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Benson JC, Trejo-Lopez J, Bach SE, Schwartz J, Kaufmann TJ, Eckel L, Guerin J. Hypothalamic Pilomyxoid Astrocytoma in a Child with Lipodystrophy. AJNR Am J Neuroradiol 2021; 42:1370-1374. [PMID: 33958332 PMCID: PMC8367624 DOI: 10.3174/ajnr.a7136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 02/16/2021] [Indexed: 11/07/2022]
Abstract
Pilomyxoid astrocytoma is a rare form of pediatric CNS malignancy first classified in 2007 by the World Health Organization. The tumors are similar to pilocytic astrocytomas, sharing both some imaging and histologic traits. However, pilomyxoid astrocytomas portend a more ominous prognosis, with more aggressive local tendencies and a greater proclivity for leptomeningeal spread. Although tissue sampling is ultimately required to differentiate pilocytic astrocytomas and pilomyxoid astrocytomas, some imaging features can be used to suggest a pilomyxoid astrocytoma, including homogeneous enhancement, leptomeningeal seeding, and lack of intratumoral cysts. In this article, a case of a hypothalamic pilomyxoid astrocytoma is described, in which the presenting disorder was profound generalized lipodystrophy. The aforementioned imaging characteristics of pilomyxoid astrocytomas are reviewed, as are the pathologic features of such tumors, including their angiocentric cellular arrangement and myxoid background.
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Affiliation(s)
- J C Benson
- Department of Radiology (J.C.B., T.J.K., L.E., J.G.), Mayo Clinic, Rochester, Minnesota
| | - J Trejo-Lopez
- Department of Laboratory Medicine and Pathology (J.T.-L.), Mayo Clinic, Rochester, Minnesota
| | - S E Bach
- Department of Laboratory Medicine and Pathology (S.E.B.), OSF Healthcare, Peoria, Illinois
| | - J Schwartz
- Departments of Pediatric and Adolescent Medicine (J.S.), Mayo Clinic, Rochester, Minnesota
| | - T J Kaufmann
- Department of Radiology (J.C.B., T.J.K., L.E., J.G.), Mayo Clinic, Rochester, Minnesota
| | - L Eckel
- Department of Radiology (J.C.B., T.J.K., L.E., J.G.), Mayo Clinic, Rochester, Minnesota
| | - J Guerin
- Department of Radiology (J.C.B., T.J.K., L.E., J.G.), Mayo Clinic, Rochester, Minnesota
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Johnson DR, Diehn FE, Giannini C, Jenkins RB, Jenkins SM, Parney IF, Kaufmann TJ. Genetically Defined Oligodendroglioma Is Characterized by Indistinct Tumor Borders at MRI. AJNR Am J Neuroradiol 2017; 38:678-684. [PMID: 28126746 DOI: 10.3174/ajnr.a5070] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 11/10/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE In 2016, the World Health Organization revised the brain tumor classification, making IDH mutation and 1p/19q codeletion the defining features of oligodendroglioma. To determine whether imaging characteristics previously associated with oligodendroglial tumors are still applicable, we evaluated the MR imaging features of genetically defined oligodendrogliomas. MATERIALS AND METHODS One hundred forty-eight adult patients with untreated World Health Organization grade II and III infiltrating gliomas with histologic oligodendroglial morphology, known 1p/19q status, and at least 1 preoperative MR imaging were retrospectively identified. The association of 1p/19q codeletion with tumor imaging characteristics and ADC values was evaluated. RESULTS Ninety of 148 (61%) patients had 1p/19q codeleted tumors, corresponding to genetically defined oligodendroglioma, and 58/148 (39%) did not show 1p/19q codeletion, corresponding to astrocytic tumors. Eighty-three of 90 (92%) genetically defined oligodendrogliomas had noncircumscribed borders, compared with 26/58 (45%) non-1p/19q codeleted tumors with at least partial histologic oligodendroglial morphology (P < .0001). Eighty-nine of 90 (99%) oligodendrogliomas were heterogeneous on T1- and/or T2-weighted imaging. In patients with available ADC values, a lower mean ADC value predicted 1p/19q codeletion (P = .0005). CONCLUSIONS Imaging characteristics of World Health Organization 2016 genetically defined oligodendrogliomas differ from the previously considered characteristics of morphologically defined oligodendrogliomas. We found that genetically defined oligodendrogliomas were commonly poorly circumscribed and were almost always heterogeneous in signal intensity.
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Affiliation(s)
- D R Johnson
- From the Departments of Radiology (D.R.J., F.E.D., T.J.K.)
| | - F E Diehn
- From the Departments of Radiology (D.R.J., F.E.D., T.J.K.)
| | | | | | | | - I F Parney
- Neurosurgery (I.F.P.), Mayo Clinic, Rochester, Minnesota
| | - T J Kaufmann
- From the Departments of Radiology (D.R.J., F.E.D., T.J.K.)
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Hu LS, Kelm Z, Korfiatis P, Dueck AC, Elrod C, Ellingson BM, Kaufmann TJ, Eschbacher JM, Karis JP, Smith K, Nakaji P, Brinkman D, Pafundi D, Baxter LC, Erickson BJ. Impact of Software Modeling on the Accuracy of Perfusion MRI in Glioma. AJNR Am J Neuroradiol 2015; 36:2242-9. [PMID: 26359151 DOI: 10.3174/ajnr.a4451] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 04/30/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Relative cerebral blood volume, as measured by T2*-weighted dynamic susceptibility-weighted contrast-enhanced MRI, represents the most robust and widely used perfusion MR imaging metric in neuro-oncology. Our aim was to determine whether differences in modeling implementation will impact the correction of leakage effects (from blood-brain barrier disruption) and the accuracy of relative CBV calculations as measured on T2*-weighted dynamic susceptibility-weighted contrast-enhanced MR imaging at 3T field strength. MATERIALS AND METHODS This study included 52 patients with glioma undergoing DSC MR imaging. Thirty-six patients underwent both non-preload dose- and preload dose-corrected DSC acquisitions, with 16 patients undergoing preload dose-corrected acquisitions only. For each acquisition, we generated 2 sets of relative CBV metrics by using 2 separate, widely published, FDA-approved commercial software packages: IB Neuro and nordicICE. We calculated 4 relative CBV metrics within tumor volumes: mean relative CBV, mode relative CBV, percentage of voxels with relative CBV > 1.75, and percentage of voxels with relative CBV > 1.0 (fractional tumor burden). We determined Pearson (r) and Spearman (ρ) correlations between non-preload dose- and preload dose-corrected metrics. In a subset of patients with recurrent glioblastoma (n = 25), we determined receiver operating characteristic area under the curve for fractional tumor burden accuracy to predict the tissue diagnosis of tumor recurrence versus posttreatment effect. We also determined correlations between rCBV and microvessel area from stereotactic biopsies (n = 29) in 12 patients. RESULTS With IB Neuro, relative CBV metrics correlated highly between non-preload dose- and preload dose-corrected conditions for fractional tumor burden (r = 0.96, ρ = 0.94), percentage > 1.75 (r = 0.93, ρ = 0.91), mean (r = 0.87, ρ = 0.86), and mode (r = 0.78, ρ = 0.76). These correlations dropped substantially with nordicICE. With fractional tumor burden, IB Neuro was more accurate than nordicICE in diagnosing tumor versus posttreatment effect (area under the curve = 0.85 versus 0.67) (P < .01). The highest relative CBV-microvessel area correlations required preload dose and IB Neuro (r = 0.64, ρ = 0.58, P = .001). CONCLUSIONS Different implementations of perfusion MR imaging software modeling can impact the accuracy of leakage correction, relative CBV calculation, and correlations with histologic benchmarks.
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Affiliation(s)
- L S Hu
- From the Department of Radiology (L.S.H.) Keller Center for Imaging Innovation (L.S.H., C.E., J.P.K., L.C.B.)
| | - Z Kelm
- the Department of Radiology (Z.K., P.K., T.J.K., B.J.E.), Mayo Clinic, Rochester, Minnesota
| | - P Korfiatis
- the Department of Radiology (Z.K., P.K., T.J.K., B.J.E.), Mayo Clinic, Rochester, Minnesota
| | - A C Dueck
- Biostatistics (A.C.D.), Mayo Clinic, Phoenix/Scottsdale, Arizona
| | - C Elrod
- Keller Center for Imaging Innovation (L.S.H., C.E., J.P.K., L.C.B.)
| | - B M Ellingson
- the Department of Radiological Sciences (B.M.E.), David Geffen School of Medicine, University of California, Los Angeles, California
| | - T J Kaufmann
- the Department of Radiology (Z.K., P.K., T.J.K., B.J.E.), Mayo Clinic, Rochester, Minnesota
| | | | - J P Karis
- Keller Center for Imaging Innovation (L.S.H., C.E., J.P.K., L.C.B.) Neuroradiology (J.P.K.)
| | - K Smith
- Neurosurgery (K.S., P.N.), Barrow Neurological Institute, Phoenix, Arizona
| | - P Nakaji
- Neurosurgery (K.S., P.N.), Barrow Neurological Institute, Phoenix, Arizona
| | - D Brinkman
- the Department of Radiation Oncology (D.B., D.P.), Mayo Clinic, Rochester, Minnesota
| | - D Pafundi
- the Department of Radiation Oncology (D.B., D.P.), Mayo Clinic, Rochester, Minnesota
| | - L C Baxter
- Keller Center for Imaging Innovation (L.S.H., C.E., J.P.K., L.C.B.)
| | - B J Erickson
- the Department of Radiology (Z.K., P.K., T.J.K., B.J.E.), Mayo Clinic, Rochester, Minnesota
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Shahgholi L, Yost KJ, Carter RE, Geske JR, Hagen CE, Amrami KK, Diehn FE, Kaufmann TJ, Morris JM, Murthy NS, Wald JT, Thielen KR, Kallmes DF, Maus TP. Correlation of the Patient Reported Outcomes Measurement Information System with legacy outcomes measures in assessment of response to lumbar transforaminal epidural steroid injections. AJNR Am J Neuroradiol 2015; 36:594-9. [PMID: 25614474 DOI: 10.3174/ajnr.a4150] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The Patient Reported Outcomes Measurement Information System is a newly developed outcomes measure promulgated by the National Institutes of Health. This study compares changes in pain and physical function-related measures of this system with changes on the Numeric Rating Pain Scale, Roland Morris Disability Index, and the European Quality of Life scale 5D questionnaire in patients undergoing transformational epidural steroid injections for radicular pain. MATERIALS AND METHODS One hundred ninety-nine patients undergoing transforaminal epidural steroid injections for radicular pain were enrolled in the study. Before the procedure, they rated the intensity of their pain by using the 0-10 Numeric Rating Pain Scale, Roland Morris Disability Index, and European Quality of Life scale 5D questionnaire. Patients completed the Patient Reported Outcomes Measurement Information System Physical Function, Pain Behavior, and Pain Interference short forms before transforaminal epidural steroid injections and at 3 and 6 months. Seventy and 43 subjects replied at 3- and 6-month follow-up. Spearman rank correlations were used to assess the correlation between the instruments. The minimally important differences were calculated for each measurement tool as an indicator of meaningful change. RESULTS All instruments were responsive in detecting changes at 3- and 6-month follow-up (P < .0001). There was significant correlation between changes in Patient Reported Outcomes Measurement Information System scores and legacy questionnaires from baseline to 3 months (P < .05). There were, however, no significant correlations in changes from 3 to 6 months with any of the instruments. CONCLUSIONS The studied Patient Reported Outcomes Measurement Information System domains offered responsive and correlative psychometric properties compared with legacy instruments in a population of patients undergoing transforaminal epidural steroid injections for radicular pain.
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Affiliation(s)
- L Shahgholi
- From the Departments of Physical Medicine and Rehabilitation (L.S.)
| | - K J Yost
- Division of Epidemiology (K.J.Y.)
| | - R E Carter
- Division of Biomedical Statistics and Informatics (R.E.C., J.R.G., C.E.H.), Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - J R Geske
- Division of Biomedical Statistics and Informatics (R.E.C., J.R.G., C.E.H.), Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - C E Hagen
- Division of Biomedical Statistics and Informatics (R.E.C., J.R.G., C.E.H.), Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - K K Amrami
- Radiology (K.K.A., F.E.D., T.J.K., J.M.M., N.S.M., J.T.W., K.R.T., D.F.K., T.P.M.), Mayo Clinic and Foundation, Rochester, Minnesota
| | - F E Diehn
- Radiology (K.K.A., F.E.D., T.J.K., J.M.M., N.S.M., J.T.W., K.R.T., D.F.K., T.P.M.), Mayo Clinic and Foundation, Rochester, Minnesota
| | - T J Kaufmann
- Radiology (K.K.A., F.E.D., T.J.K., J.M.M., N.S.M., J.T.W., K.R.T., D.F.K., T.P.M.), Mayo Clinic and Foundation, Rochester, Minnesota
| | - J M Morris
- Radiology (K.K.A., F.E.D., T.J.K., J.M.M., N.S.M., J.T.W., K.R.T., D.F.K., T.P.M.), Mayo Clinic and Foundation, Rochester, Minnesota
| | - N S Murthy
- Radiology (K.K.A., F.E.D., T.J.K., J.M.M., N.S.M., J.T.W., K.R.T., D.F.K., T.P.M.), Mayo Clinic and Foundation, Rochester, Minnesota
| | - J T Wald
- Radiology (K.K.A., F.E.D., T.J.K., J.M.M., N.S.M., J.T.W., K.R.T., D.F.K., T.P.M.), Mayo Clinic and Foundation, Rochester, Minnesota
| | - K R Thielen
- Radiology (K.K.A., F.E.D., T.J.K., J.M.M., N.S.M., J.T.W., K.R.T., D.F.K., T.P.M.), Mayo Clinic and Foundation, Rochester, Minnesota
| | - D F Kallmes
- Radiology (K.K.A., F.E.D., T.J.K., J.M.M., N.S.M., J.T.W., K.R.T., D.F.K., T.P.M.), Mayo Clinic and Foundation, Rochester, Minnesota
| | - T P Maus
- Radiology (K.K.A., F.E.D., T.J.K., J.M.M., N.S.M., J.T.W., K.R.T., D.F.K., T.P.M.), Mayo Clinic and Foundation, Rochester, Minnesota
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Schmidt KA, Huang JF, Black DF, Kaufmann TJ, Lanzino G, Kumar N. Spinal dural arteriovenous fistula with intramedullary cord hemorrhage: Diagnostic challenges. Neurol Clin Pract 2014. [DOI: 10.1212/cpj.0000000000000062] [Citation(s) in RCA: 2] [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: 11/15/2022]
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Diehn FE, Rykken JB, Wald JT, Wood CP, Eckel LJ, Hunt CH, Schwartz KM, Lingineni RK, Carter RE, Kaufmann TJ. Intramedullary spinal cord metastases: prognostic value of MRI and clinical features from a 13-year institutional case series. AJNR Am J Neuroradiol 2014; 36:587-93. [PMID: 25395656 DOI: 10.3174/ajnr.a4160] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE In patients with intramedullary spinal cord metastases, the impact of MR imaging and clinical characteristics on survival has not been elucidated. Our aim was to identify MR imaging and clinical features with prognostic value among patients with intramedullary spinal cord metastases from a large retrospective series. MATERIALS AND METHODS The relevant MR imaging examination and baseline clinical data for each patient from a consecutive group of patients with intramedullary spinal cord metastases had previously been reviewed by 2 neuroradiologists. Additional relevant clinical data were extracted. The influence of clinical and imaging characteristics on survival was assessed by Kaplan-Meier survival curves and log-rank tests for categoric characteristics. RESULTS Forty-nine patients had 70 intramedullary spinal cord metastases; 10 (20%) of these patients had multiple metastases. From the date of diagnosis, median survival for all patients was 104 days (95% CI, 48-156 days). One clinical feature was associated with decreased median survival: lung or breast primary malignancy (57 days) compared with all other malignancy types (308 days; P < .001). Three MR imaging features were associated with decreased median survival: multiple intramedullary spinal cord metastases (53 versus 121 days, P = .022), greater longitudinal extent of cord T2 hyperintensity (if ≥3 segments, 111 days; if ≤2, 184 days; P = .018), and ancillary visualization of the primary tumor and/or non-CNS metastases (96 versus 316 days, P = .012). CONCLUSIONS Spinal cord edema spanning multiple segments, the presence of multifocal intramedullary spinal cord metastases, and ancillary evidence for non-CNS metastases and/or the primary tumor are MR imaging features associated with decreased survival and should be specifically sought. Patients with either a lung or breast primary malignancy are expected to have decreased survival compared with other primary tumor types.
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Affiliation(s)
- F E Diehn
- From the Division of Neuroradiology (F.E.D., J.B.R., J.T.W., C.P.W., L.J.E., C.H.H., K.M.S., T.J.K.), Department of Radiology
| | - J B Rykken
- From the Division of Neuroradiology (F.E.D., J.B.R., J.T.W., C.P.W., L.J.E., C.H.H., K.M.S., T.J.K.), Department of Radiology
| | - J T Wald
- From the Division of Neuroradiology (F.E.D., J.B.R., J.T.W., C.P.W., L.J.E., C.H.H., K.M.S., T.J.K.), Department of Radiology
| | - C P Wood
- From the Division of Neuroradiology (F.E.D., J.B.R., J.T.W., C.P.W., L.J.E., C.H.H., K.M.S., T.J.K.), Department of Radiology
| | - L J Eckel
- From the Division of Neuroradiology (F.E.D., J.B.R., J.T.W., C.P.W., L.J.E., C.H.H., K.M.S., T.J.K.), Department of Radiology
| | - C H Hunt
- From the Division of Neuroradiology (F.E.D., J.B.R., J.T.W., C.P.W., L.J.E., C.H.H., K.M.S., T.J.K.), Department of Radiology
| | - K M Schwartz
- From the Division of Neuroradiology (F.E.D., J.B.R., J.T.W., C.P.W., L.J.E., C.H.H., K.M.S., T.J.K.), Department of Radiology
| | - R K Lingineni
- Department of Health Sciences Research (R.K.L., R.E.C.), Mayo Clinic, Rochester, Minnesota
| | - R E Carter
- Department of Health Sciences Research (R.K.L., R.E.C.), Mayo Clinic, Rochester, Minnesota
| | - T J Kaufmann
- From the Division of Neuroradiology (F.E.D., J.B.R., J.T.W., C.P.W., L.J.E., C.H.H., K.M.S., T.J.K.), Department of Radiology
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Štepán-Buksakowska IL, Accurso JM, Diehn FE, Huston J, Kaufmann TJ, Luetmer PH, Wood CP, Yang X, Blezek DJ, Carter R, Hagen C, Hořínek D, Hejčl A, Roček M, Erickson BJ. Computer-aided diagnosis improves detection of small intracranial aneurysms on MRA in a clinical setting. AJNR Am J Neuroradiol 2014; 35:1897-902. [PMID: 24924543 DOI: 10.3174/ajnr.a3996] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND PURPOSE MRA is widely accepted as a noninvasive diagnostic tool for the detection of intracranial aneurysms, but detection is still a challenging task with rather low detection rates. Our aim was to examine the performance of a computer-aided diagnosis algorithm for detecting intracranial aneurysms on MRA in a clinical setting. MATERIALS AND METHODS Aneurysm detectability was evaluated retrospectively in 48 subjects with and without computer-aided diagnosis by 6 readers using a clinical 3D viewing system. Aneurysms ranged from 1.1 to 6.0 mm (mean = 3.12 mm, median = 2.50 mm). We conducted a multireader, multicase, double-crossover design, free-response, observer-performance study on sets of images from different MRA scanners by using DSA as the reference standard. Jackknife alternative free-response operating characteristic curve analysis with the figure of merit was used. RESULTS For all readers combined, the mean figure of merit improved from 0.655 to 0.759, indicating a change in the figure of merit attributable to computer-aided diagnosis of 0.10 (95% CI, 0.03-0.18), which was statistically significant (F(1,47) = 7.00, P = .011). Five of the 6 radiologists had improved performance with computer-aided diagnosis, primarily due to increased sensitivity. CONCLUSIONS In conditions similar to clinical practice, using computer-aided diagnosis significantly improved radiologists' detection of intracranial DSA-confirmed aneurysms of ≤6 mm.
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Affiliation(s)
- I L Štepán-Buksakowska
- From the Department of Radiology (I.L.Š.-B., F.E.D., J.H., T.J.K., P.H.L., C.P.W., B.J.E.) International Clinical Research Center (I.L.Š.-B., D.H., A.H.), St. Anne's University Hospital Brno, Brno, Czech Republic Department of Radiology (I.L.Š.-B., M.R.), Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - J M Accurso
- Department of Radiology (J.M.A.), Mayo Clinic, Jacksonville, Florida
| | - F E Diehn
- From the Department of Radiology (I.L.Š.-B., F.E.D., J.H., T.J.K., P.H.L., C.P.W., B.J.E.)
| | - J Huston
- From the Department of Radiology (I.L.Š.-B., F.E.D., J.H., T.J.K., P.H.L., C.P.W., B.J.E.)
| | - T J Kaufmann
- From the Department of Radiology (I.L.Š.-B., F.E.D., J.H., T.J.K., P.H.L., C.P.W., B.J.E.)
| | - P H Luetmer
- From the Department of Radiology (I.L.Š.-B., F.E.D., J.H., T.J.K., P.H.L., C.P.W., B.J.E.)
| | - C P Wood
- From the Department of Radiology (I.L.Š.-B., F.E.D., J.H., T.J.K., P.H.L., C.P.W., B.J.E.)
| | - X Yang
- Department of Information Services (X.Y., D.J.B.), Mayo Clinic, Rochester, Minnesota
| | - D J Blezek
- Department of Information Services (X.Y., D.J.B.), Mayo Clinic, Rochester, Minnesota
| | - R Carter
- Division of Biomedical Statistics and Informatics (R.C., C.H.)
| | - C Hagen
- Division of Biomedical Statistics and Informatics (R.C., C.H.)
| | - D Hořínek
- International Clinical Research Center (I.L.Š.-B., D.H., A.H.), St. Anne's University Hospital Brno, Brno, Czech Republic Department of Neurosurgery (D.H., A.H.), Masaryk Hospital, Ústí nad Labem, Czech Republic Department of Neurosurgery (D.H.), Central Military Hospital, Prague, Czech Republic
| | - A Hejčl
- International Clinical Research Center (I.L.Š.-B., D.H., A.H.), St. Anne's University Hospital Brno, Brno, Czech Republic Department of Neurosurgery (D.H., A.H.), Masaryk Hospital, Ústí nad Labem, Czech Republic
| | - M Roček
- Department of Radiology (I.L.Š.-B., M.R.), Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - B J Erickson
- From the Department of Radiology (I.L.Š.-B., F.E.D., J.H., T.J.K., P.H.L., C.P.W., B.J.E.)
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Lehman VT, Murphy RC, Kaufmann TJ, Diehn FE, Murthy NS, Wald JT, Thielen KR, Amrami KK, Morris JM, Maus TP. Frequency of discordance between facet joint activity on technetium Tc99m methylene diphosphonate SPECT/CT and selection for percutaneous treatment at a large multispecialty institution. AJNR Am J Neuroradiol 2013; 35:609-14. [PMID: 24029387 DOI: 10.3174/ajnr.a3731] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE The clinical impact of facet joint bone scan activity is not fully understood. The hypothesis of this study is that facet joints targeted for percutaneous treatment in clinical practice differ from those with reported activity on technetium Tc99m methylene diphosphonate SPECT/CT. MATERIALS AND METHODS All patients with a technetium Tc99m methylene diphosphonate SPECT/CT scan of the lumbar or cervical spine who underwent subsequent percutaneous facet joint steroid injection or comparative medial branch blocks at our institution between January 1, 2008, and February 19, 2013, were identified. Facet joints with increased activity were compared with those treated. A chart review characterized the clinical reasons for treatment discrepancies. RESULTS Of 74 patients meeting inclusion criteria, 52 (70%) had discrepant imaging findings and treatment selection of at least 1 facet joint, whereas 34 patients (46%) had a side (right vs left) discrepancy. Only 92 (70%) of 132 facet joints with increased activity were treated, whereas 103 (53%) of 195 of treated facet joints did not have increased activity. The most commonly documented clinical rationale for discrepancy was facet joint activity that was not thought to correlate with clinical findings, cited in 18 (35%) of 52 patients. CONCLUSIONS Facet joints undergoing targeted percutaneous treatment were frequently discordant with those demonstrating increased technetium Tc99m methylene diphosphonate activity identified by SPECT/CT at our institution, in many cases because the active facet joint(s) did not correlate with clinical findings. Further prospective double-blinded investigations of the clinical significance of facet joint activity by use of technetium Tc99m methylene diphosphonate SPECT/CT and comparative medial branch blocks are needed.
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Affiliation(s)
- V T Lehman
- From the Department of Radiology, Mayo Clinic College of Graduate Medical Education, Rochester, Minnesota
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Mostardi PM, Diehn FE, Rykken JB, Eckel LJ, Schwartz KM, Kaufmann TJ, Wood CP, Wald JT, Hunt CH. Intramedullary spinal cord metastases: visibility on PET and correlation with MRI features. AJNR Am J Neuroradiol 2013; 35:196-201. [PMID: 23886743 DOI: 10.3174/ajnr.a3618] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Studies systematically evaluating the detection of intramedullary spinal cord metastasis with PET are lacking. Our purpose was to evaluate the visibility of intramedullary spinal cord metastasis on PET in a single institutional series and to correlate PET and MR imaging features. MATERIALS AND METHODS Patients were included if pretreatment MR imaging identifying an intramedullary spinal cord metastasis and an [(18)F] FDG-PET examination near the time of MR imaging were available. PET examinations were retrospectively reviewed, with reviewers blinded and then unblinded to the PET report and MR imaging findings. PET intramedullary spinal cord metastasis features were compared with and correlated with previously analyzed MR imaging lesion characteristics. Original clinical PET reports were reviewed. RESULTS The final study sample was 10 PET examinations in 10 patients with 13 intramedullary spinal cord metastases. In 7 (70%) patients, retrospective blinded review demonstrated convincing evidence of 10 (77%) intramedullary spinal cord metastases. Three MR imaging features correlated with intramedullary spinal cord metastases being visible on PET compared with those nonvisible, respectively: larger lesion enhancement size: mean size: 32.1 mm versus 6.0 mm (P = .038); larger longitudinal extent of T2 signal abnormality: mean 5.6 versus 1.0 segments (P = .0081); and larger ratio of extent of T2 signal abnormality to contrast enhancement: 3.8 versus 1.0 (P = .0069). Intramedullary spinal cord metastasis was confidently reported clinically in 2 (20%) patients, accounting for 5 (38%) intramedullary spinal cord metastases. CONCLUSIONS Most intramedullary spinal cord metastases can be detected on PET when performed near the time of pretreatment MR imaging. However, intramedullary spinal cord metastases may not be clinically reported on PET. Larger lesions with more edema are more likely to be visible. The spinal cord should be specifically and carefully assessed on PET for evidence of intramedullary spinal cord metastases to provide timely diagnosis.
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Rykken JB, Diehn FE, Hunt CH, Schwartz KM, Eckel LJ, Wood CP, Kaufmann TJ, Lingineni RK, Carter RE, Wald JT. Intramedullary spinal cord metastases: MRI and relevant clinical features from a 13-year institutional case series. AJNR Am J Neuroradiol 2013; 34:2043-9. [PMID: 23620071 DOI: 10.3174/ajnr.a3526] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND AND PURPOSE Because intramedullary spinal cord metastasis is often a difficult diagnosis to make, our purpose was to perform a systematic review of the MR imaging and relevant baseline clinical features of intramedullary spinal cord metastases in a large series. MATERIALS AND METHODS Consecutive patients with intramedullary spinal cord metastasis with available pretreatment digital MR imaging examinations were identified. The MR imaging examination(s) for each patient was reviewed by 2 neuroradiologists for various imaging characteristics. Relevant clinical data were obtained. RESULTS Forty-nine patients had 70 intramedullary spinal cord metastases, with 10 (20%) having multiple intramedullary spinal cord metastases; 8% (4/49) were asymptomatic. Primary tumor diagnosis was preceded by intramedullary spinal cord metastasis presentation in 20% (10/49) and by intramedullary spinal cord metastasis diagnosis in 10% (5/49); 98% (63/64) of intramedullary spinal cord metastases enhanced. Cord edema was extensive: mean, 4.5 segments, 3.6-fold larger than enhancing lesion, and ≥3 segments in 54% (37/69). Intratumoral cystic change was seen in 3% (2/70) and hemorrhage in 1% (1/70); 59% (29/49) of reference MR imaging examinations displayed other CNS or spinal (non-spinal cord) metastases, and 59% (29/49) exhibited the primary tumor/non-CNS metastases, with 88% (43/49) displaying ≥1 finding and 31% (15/49) displaying both findings. Patients with solitary intramedullary spinal cord metastasis were less likely than those with multiple intramedullary spinal cord metastases to have other CNS or spinal (non-spinal cord) metastases on the reference MR imaging (20/39 [51%] versus 9/10 [90%], respectively; P = .0263). CONCLUSIONS Lack of known primary malignancy or spinal cord symptoms should not discourage consideration of intramedullary spinal cord metastasis. Enhancement and extensive edema for lesion size (often ≥3 segments) are typical for intramedullary spinal cord metastasis. Presence of cystic change/hemorrhage makes intramedullary spinal cord metastasis unlikely. Evidence for other CNS or spinal (non-spinal cord) metastases and the primary tumor/non-CNS metastases are common. The prevalence of other CNS or spinal (non-spinal cord) metastases in those with multiple intramedullary spinal cord metastases is especially high.
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Affiliation(s)
- J B Rykken
- Division of Neuroradiology, Department of Radiology
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Wald JT, Maus TP, Geske JR, Diehn FE, Kaufmann TJ, Murthy NS, Thielen KR, Watson S. Immediate pain response does not predict long-term outcome of CT-guided cervical transforaminal epidural steroid injections. AJNR Am J Neuroradiol 2013; 34:1665-8. [PMID: 23449654 DOI: 10.3174/ajnr.a3439] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Imaging-guided cervical transforaminal epidural steroid injections have been shown to decrease verbal numerical pain scores and improve functionality (Roland Morris Disability Index). These injections are often administered in combination with local anesthetic. The purpose of this study was to determine if the immediate postprocedure VNPS predicts the long-term effectiveness of the injection. MATERIALS AND METHODS A quality assurance data base review of 247 patient records was used to document the VNPS and RMDI of patients undergoing a single CT-guided CTESI. Pain scores were recorded before the procedure, immediately after the procedure, at 2 weeks, and at 2 months. The RMDI was recorded before the procedure, at 2 weeks, and at 2 months. Spearman rank correlation analysis and logistic regression models were used to determine if the immediate postprocedure or 2-week VNPS correlated with or predicted the longer-term VNPS and RMDI as measured at 2 weeks and 2 months. RESULTS There was not a strong correlation between the pain score obtained immediately after the procedure and the 2-month outcome of the VNPS or RMDI. The pain scores at 2 weeks did correlate with the 2-month outcomes. The 2-week VNPS also was a significant predictor of patients who would achieve a >50% improvement in VNPS or RMDI at 2 months. CONCLUSIONS Pain scores obtained immediately after completion of a single CT-guided CTESI do not predict the long-term effectiveness of this procedure. However, patient response at 2 weeks does correlate with the long-term effectiveness of these injections as measured by the VNPS and the RMDI.
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Affiliation(s)
- J T Wald
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
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Rykken JB, Diehn FE, Hunt CH, Eckel LJ, Schwartz KM, Kaufmann TJ, Wald JT, Giannini C, Wood CP. Rim and flame signs: postgadolinium MRI findings specific for non-CNS intramedullary spinal cord metastases. AJNR Am J Neuroradiol 2012; 34:908-15. [PMID: 23079405 DOI: 10.3174/ajnr.a3292] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE No highly specific MR imaging features distinguishing ISCMs from primary cord masses have been described. Our purpose was to retrospectively compare peripheral enhancement features on postgadolinium MR imaging of ISCMs with primary intramedullary cord masses. MATERIALS AND METHODS A consecutive group of patients with firmly diagnosed ISCM (45 patients with 64 ISCMs) and a comparison group with consecutive pathologically proved primary intramedullary spinal cord masses (64 patients with 64 primary spinal cord masses: ependymoma, astrocytoma, hemangioblastoma, ganglioglioma, and cavernous malformation) were included. MR images were evaluated for 2 specific signs on postgadolinium images: a "rim" sign (more intense thin rim of peripheral enhancement around an enhancing lesion) and "flame" sign (ill-defined flame-shaped region of enhancement at the superior/inferior lesion margins). The frequency of rim and/or flame signs in ISCMs and primary cord masses was compared (χ2 test). For ISCMs, the maximal dimension of the enhancing lesion was correlated with the presence of rim or flame signs (t test). RESULTS Rim and flame signs, alone and in combination, were seen more frequently in ISCMs than in primary cord masses (P<.0001 for each). Specificity and sensitivity, respectively, for diagnosing ISCMs among spinal cord masses on a per-patient basis were the following: rim sign, 97%, 47%; flame sign, 97%, 40%; at least 1 sign, 94%, 60%; and both signs concurrently, 100%, 27%. In the ISCM group, the presence of either a rim or flame sign correlated with a larger measured maximum enhancing lesion size (P=.0065 and P=.0012, respectively). CONCLUSIONS The rim and flame signs are common in and specific for ISCM and are rare in primary spinal cord masses.
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Affiliation(s)
- J B Rykken
- Department of Radiology, Division of Neuroradiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
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Wald JT, Maus TP, Geske JR, Carter RE, Diehn FE, Kaufmann TJ, Morris JM, Murthy NS, Thielen KR. Safety and efficacy of CT-guided transforaminal cervical epidural steroid injections using a posterior approach. AJNR Am J Neuroradiol 2011; 33:415-9. [PMID: 22207298 DOI: 10.3174/ajnr.a2835] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Image-guided cervical transforaminal epidural injections play an important role in the management of cervical radicular pain syndromes. The safety and efficacy of these injections via an anterolateral approach has been well-studied. The goal of this retrospective review was to determine the safety and efficacy of CT-guided transforaminal epidural injections by using a posterior approach. MATERIALS AND METHODS Retrospective review of patient records was used to define VNPS and RMDI of patients undergoing CT-guided transforaminal cervical epidural injections between 2006 and 2010. Pain scores were recorded preprocedure, immediately postprocedure, at 2 weeks, and at 2 months. The RMDI was recorded preprocedure, at 2 weeks, and at 2 months. Data analysis of 247 patients was completed. Differences in VNPS scores and the RMDI were then compared on the basis of a CT-guided approach (anterolateral versus posterior). RESULTS There was no statistical difference in the degree of pain relief and improvement in the RMDI between the CT-guided transforaminal anterolateral approach and the posterior approach at 2 weeks and at 2 months. Both groups demonstrated a statistically significant improvement in pain scores and the RMDI. Approximately 35% of patients in both groups demonstrated >50% pain relief at 2 months. There were no serious complications in either group. CONCLUSIONS CT-guided transforaminal cervical epidural injections by using a posterior approach are safe and effective.
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Affiliation(s)
- J T Wald
- Mayo Clinic, Rochester, Minnesota 55905, USA.
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Fuehrer NE, Hammack JE, Morris JM, Kaufmann TJ, Giannini C. Teaching NeuroImages: Granulomatous angiitis of the CNS associated with Hodgkin lymphoma. Neurology 2011; 77:e110-1. [DOI: 10.1212/wnl.0b013e318236eefb] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC, Zhou T, Meng X, Xu B, Wei S, Chen X, De Witt Hamer PC, Robles SG, Zwinderman AH, Duffau H, Berger MS, Gonzalez JDSR, Alberto OV, Patricia HM, Chaichana K, Pendleton C, Chambless L, Nathan J, Camara-Quintana J, Li G, Harsh G, Thompson R, Lim M, Quinones-Hinojosa A, Oppenlander ME, Wolf A, Porter R, Nakaji P, Smith KA, Spetzler RF, Sanai N, Kim JH, Clark AJ, Jahangiri A, Sughrue ME, McDermott MW, Aghi MK, Chen C, Kasper E, Warnke P, Park CK, Lee SH, Song SW, Kim JW, Kim TM, Yamaguchi F, Omura T, Ten H, Ishii Y, Kojima T, Takahashi H, Teramoto A, Pereira EA, Livermore J, Ansorge O, Bojanic S, Meng X, Xu B, Chen X, Wei S, Zhou T, Tong H, Yu X, Zhou D, Hou Y, Zhou Z, Zhang J, Fabiano AJ, Rigual N, Munich S, Fenstermaker RA, Chen X, Meng X, Zhang J, Wang F, Zhao Y, Xu BN, Kim EH, Oh MC, Lee EJ, Kim SH, Kim YH, Kim CY, Kim YH, Han JH, Park CK, Kim SK, Paek SH, Wang KC, Kim DG, Jung HW, Chen X, Meng X, Wang F, Zhao Y, Xu BN, Krex D, Lindner C, Juratli T, Raue C, Schackert G, Valdes PA, Kim A, Leblond F, Conde OM, Harris BT, Paulsen KD, Wilson BC, Roberts DW, Krex D, Juratli T, Lindner C, Raue C, Schackert G, Occhiogrosso G, Cascardi P, Blagia M, De Tommasi A, Gelinas-Phaneuf N, Choudhury N, Al-Habib A, Cabral A, Nadeau E, Vincent M, Pazos V, Debergue P, DiRaddo R, Del Maestro RF, Guha-Thakurta N, Prabhu SS, Schulder M, Zavarella S, Nardi D, Schaffer S, Ruge MI, Grau S, Fuetsch M, Kickingereder P, Hamisch C, Treuer H, Voges J, Sturm V, Choy W, Yew A, Spasic M, Nagasawa D, Kim W, Yang I, Quigley MR, Hobbs J, Bhatia S, Cohen ZR, Shimon I, Hadani M, Carapella CM, Oppido PA, Vidiri A, Telera S, Pompili A, Villani V, Fabi A, Pace A, Cahill D, Wang M, Won M, Aldape K, Maywald R, Hegi M, Mehta M, Gilbert M, Sulman E, Vogelbaum M, Narayana A, Kunnakkat SD, Parker E, Gruber D, Gruber M, Knopp E, Zagzag D, Golfinos J, Dziurzynski K, Blas-Boria D, Suki D, Cahill D, Prabhu S, Puduvalli V, Levine N, Bloch O, Han SJ, Kaur G, Aghi MK, McDermott MW, Berger MS, Parsa AT, Quigley MR, Fukui O, Chew B, Bhatia S, DePowell JJ, Sanders-Taylor C, Guarnaschelli J, McPherson C, Sheth SA, Snuderl M, Kwon CS, Wirth D, Yaroslavsky A, Curry WT, Vogelbaum MA, Wang M, Hadjipanayis CG, Won M, Mehta MP, Gilbert MR, Megyesi JF, Macdonald D, Wang B, Pierre GHS, Hoover JM, Goerss SJ, Kaufmann TJ, Meyer FB, Parney IF, Guthikonda B, Thakur J, Khan I, Ahmed O, Shorter C, Wilson J, Welsh J, Cuellar H, Jeroudi M. SURGICAL THERAPIES. Neuro Oncol 2011; 13:iii154-iii163. [PMCID: PMC3222965 DOI: 10.1093/neuonc/nor164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023] Open
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Bluml S, Panigrahy A, Laskov M, Dhall G, Nelson MD, Finlay JL, Gilles FH, Arita H, Kinoshita M, Kagawa N, Fujimoto Y, Hashimoto N, Yoshimine T, Kinoshita M, Arita H, Kagawa N, Fujimoto Y, Hashimoto N, Yoshimine T, Hamilton JD, Wang J, Levin VA, Hou P, Loghin ME, Gilbert MR, Leeds NE, deGroot JF, Puduvalli V, Jackson EF, Yung WKA, Kumar AJ, Ellingson BM, Cloughesy TF, Pope WB, Zaw T, Phillips H, Lalezari S, Nghiemphu PL, Ibrahim H, Motevalibashinaeini K, Lai A, Ellingson BM, Cloughesy TF, Zaw T, Harris R, Lalezari S, Nghiemphu PL, Motevalibashinaeini K, Lai A, Pope WB, Douw L, Van de Nieuwenhuijzen ME, Heimans JJ, Baayen JC, Stam CJ, Reijneveld JC, Juhasz C, Mittal S, Altinok D, Robinette NL, Muzik O, Chakraborty PK, Barger GR, Ellingson BM, Cloughesy TF, Zaw TM, Lalezari S, Nghiemphu PL, Motevalibashinaeini K, Lai A, Goldin J, Pope WB, Ellingson BM, Cloughesy TF, Harris R, Pope WB, Nghiemphu PL, Lai A, Zaw T, Chen W, Ahlman MA, Giglio P, Kaufmann TJ, Anderson SK, Jaeckle KA, Uhm JH, Northfelt DW, Flynn PJ, Buckner JC, Galanis E, Zalatimo O, Weston C, Allison D, Bota D, Kesari S, Glantz M, Sheehan J, Harbaugh RE, Chiba Y, Kinoshita M, Kagawa N, Fujimoto Y, Tsuboi A, Hatazawa J, Sugiyama H, Hashimoto N, Yoshimine T, Nariai T, Toyohara J, Tanaka Y, Inaji M, Aoyagi M, Yamamoto M, Ishiwara K, Ohno K, Jalilian L, Essock-Burns E, Cha S, Chang S, Prados M, Butowski N, Nelson S, Kawahara Y, Nakada M, Hayashi Y, Kai Y, Hayashi Y, Uchiyama N, Kuratsu JI, Hamada JI, Yeom K, Rosenberg J, Andre JB, Fisher PG, Edwards MS, Barnes PD, Partap S, Essock-Burns E, Jalilian L, Lupo JM, Crane JC, Cha S, Chang SM, Nelson SJ, Romanowski CA, Hoggard N, Jellinek DA, Clenton S, McKevitt F, Wharton S, Craven I, Buller A, Waddle C, Bigley J, Wilkinson ID, Metherall P, Eckel LJ, Keating GF, Wetjen NM, Giannini C, Wetmore C, Jain R, Narang J, Arbab AS, Schultz L, Scarpace L, Mikkelsen T, Babajni-Feremi A, Jain R, Poisson L, Narang J, Scarpace L, Gutman D, Jaffe C, Saltz J, Flanders A, Daniel B, Mikkelsen T, Zach L, Guez D, Last D, Daniels D, Hoffman C, Mardor Y, Guha-Thakurta N, Debnam JM, Kotsarini C, Wilkinson ID, Jellinek D, Griffiths PD, Khandanpour N, Hoggard N, Kotsarini C, Wilkinson ID, Jellinek D, Griffiths PD, Bambrough P, Hoggard N, Hamilton JD, Levin VA, Hou P, Prabhu S, Loghin ME, Gilbert MR, Bassett RL, Wang J, Yung WA, Jackson EF, Kumar AJ, Campen CJ, Soman S, Fisher PG, Edwards MS, Yeom KW, Vos MJ, Berkhof J, Postma TJ, Sanchez E, Sizoo EM, Heimans JJ, Lagerwaard FJ, Buter J, Noske DP, Reijneveld JC, Colen RR, Mahajan B, Jolesz FA, Zinn PO, Lupo JM, Molinaro A, Chang S, Lawton K, Cha S, Nelson SJ, Alexandru D, Bota D, Linskey ME, Chaumeil MM, Gini B, Yang H, Iwanami A, Subramanian S, Ozawa T, Read EJ, Pieper RO, Mischel P, James CD, Ronen SM, LaViolette PS, Cochran E, Al-Gizawiy M, Connelly JM, Malkin MG, Rand SD, Mueller WM, Schmainda KM, LaViolette PS, Cohen AD, Cochran E, Prah M, Hartman CJ, Connelly JM, Rand SD, Malkin MG, Mueller WM, Schmainda KM, Qiao XJ, He R, Brown M, Goldin J, Cloughesy T, Pope WB. RADIOLOGY. Neuro Oncol 2011; 13:iii136-iii144. [PMCID: PMC3222969 DOI: 10.1093/neuonc/nor162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
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Prithviraj GK, Sommers SR, Jump RL, Halmos B, Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC, Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC, Hunter K, Chamberlain MC, Le EM, Lee ELT, Chamberlain MC, Sadighi ZS, Pearlman ML, Slopis JM, Vats TS, Khatua S, DeVito NC, Yu M, Chen R, Pan E, Cloughesy T, Raizer J, Drappatz J, Gerena-Lewis M, Rogerio J, Yacoub S, Desjardin A, Groves MD, DeGroot J, Loghin M, Conrad CA, Hess K, Ni J, Ictech S, Hunter K, Yung WA, Porter AB, Dueck AC, Karlin NJ, Chamberlain MC, Olson J, Silber J, Reiner AS, Panageas KS, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL, Eichler AF, Louis DN, Paleologos NA, Fisher BJ, Ashby LS, Cairncross JG, Roldan GB, Wen PY, Ligon KL, Shiff D, Robins HI, Rocque BG, Chamberlain MC, Mason WP, Weaver SA, Green RM, Kamar FG, Abrey LE, DeAngelis LM, Jhanwar SC, Rosenblum MK, Lassman AB, Cachia D, Alderson L, Moser R, Smith T, Yunus S, Saito K, Mukasa A, Narita Y, Tabei Y, Shinoura N, Shibui S, Saito N, Flechl B, Ackerl M, Sax C, Dieckmann K, Crevenna R, Widhalm G, Preusser M, Marosi C, Marosi C, Ay C, Preusser M, Dunkler D, Widhalm G, Pabinger I, Dieckmann K, Zielinski C, Belongia M, Jogal S, Schlingensiepen KH, Bogdahn U, Stockhammer G, Mahapatra AK, Venkataramana NK, Oliushine V, Parfenov V, Poverennova I, Hau P, Jachimczak P, Heinrichs H, Mammoser AG, Shonka NA, de Groot JF, Shibahara I, Sonoda Y, Kumabe T, Saito R, Kanamori M, Yamashita Y, Watanabe M, Ishioka C, Tominaga T, Silvani A, Gaviani P, Lamperti E, Botturi A, DiMeco F, Broggi G, Fariselli L, Solero CL, Salmaggi A, Green RM, Woyshner EA, Cloughesy TF, Shu F, Oh YS, Iganej S, Singh G, Vemuri SL, Theeler BJ, Ellezam B, Gilbert MR, Aoki T, Kobayashi H, Takano S, Nishikawa R, Shinoura N, Nagane M, Narita Y, Muragaki Y, Sugiyama K, Kuratsu J, Matsutani M, Sadighi ZS, Khatua S, Langford LA, Puduvalli VK, Shen D, Chen ZP, Zhang JP, Chen ZP, Bedekar D, Rand S, Connelly J, Malkin M, Paulson E, Mueller W, Schmainda K, Gallego O, Benavides M, Segura PP, Balana C, Gil M, Berrocal A, Reynes G, Garcia JL, Murata P, Bague S, Quintana MJ, Vasishta VG, Nagane M, Kobayashi K, Tanaka M, Tsuchiya K, Shiokawa Y, Bavle AA, Ayyanar K, Puduvalli VK, Prado MP, Hess KR, Hunter K, Ictech S, Groves MD, Gilbert MR, Liu V, Conrad CA, de Groot J, Loghin ME, Colman H, Levin VA, Alfred Yung WK, Hackney JR, Palmer CA, Markert JM, Cure J, Riley KO, Fathallah-Shaykh H, Nabors LB, Saria MG, Corle C, Hu J, Rudnick J, Phuphanich S, Mrugala MM, Lee LK, Fu BD, Bota DA, Kim RY, Brown T, Feely H, Hu A, Drappatz J, Wen PY, Lee JW, Carter B, Kesari S, Fu BD, Kong XT, Bota DA, Fu BD, Bota DA, Sparagana S, Belousova E, Jozwiak S, Korf B, Frost M, Kuperman R, Kohrman M, Witt O, Wu J, Flamini R, Jansen A, Curtalolo P, Thiele E, Whittemore V, De Vries P, Ford J, Shah G, Cauwel H, Edrich P, Sahmoud T, Franz D, Khasraw M, Brown C, Ashley DM, Rosenthal MA, Jiang X, Mou YG, Chen ZP, Oh M, kim E, Chang J, Juratli TA, Kirsch M, Schackert G, Krex D, Gilbert MR, Wang M, Aldape KD, Stupp R, Hegi M, Jaeckle KA, Armstrong TS, Wefel JS, Won M, Blumenthal DT, Mahajan A, Schultz CJ, Erridge SC, Brown PD, Chakravarti A, Curran WJ, Mehta MP, Hofland KF, Hansen S, Sorensen M, Schultz H, Muhic A, Engelholm S, Ask A, Kristiansen C, Thomsen C, Poulsen HS, Lassen UN, Zalatimo O, Weston C, Zoccoli C, Glantz M, Rahmanuddin S, Shiroishi MS, Cen SY, Jones J, Chen T, Pagnini P, Go J, Lerner A, Gomez J, Law M, Ram Z, Wong ET, Gutin PH, Bobola MS, Alnoor M, Silbergeld DL, Rostomily RC, Chamberlain MC, Silber JR, Martha N, Jacqueline S, Thaddaus G, Daniel P, Hans M, Armin M, Eugen T, Gunther S, Hutterer M, Tseng HM, Zoccoli CM, Glantz M, Zalatimo O, Patel A, Rizzo K, Sheehan JM, Sumrall AL, Vredenburgh JJ, Desjardins A, Reardon DA, Friiedman HS, Peters KB, Taylor LP, Stewart M, Blondin NA, Baehring JM, Foote T, Laack N, Call J, Hamilton MG, Walling S, Eliasziw M, Easaw J, Shirsat NV, Kundar R, Gokhale A, Goel A, Moiyadi AA, Wang J, Mutlu E, Oyan A, Yan T, Tsinkalovsky O, Jacobsen HK, Talasila KM, Sleire L, Pettersen K, Miletic H, Andersen S, Mitra S, Weissman I, Li X, Kalland KH, Enger PO, Sepulveda J, Belda C, Balana C, Segura PP, Reynes G, Gil M, Gallego O, Berrocal A, Blumenthal DT, Sitt R, Phishniak L, Bokstein F, Philippe M, Carole C, Andre MDP, Marylin B, Olivier C, L'Houcine O, Dominique FB, Philippe M, Isabelle NM, Olivier C, Frederic F, Stephane F, Henry D, Marylin B, L'Houcine O, Dominique FB, Errico MA, Kunschner LJ, Errico MA, Kunschner LJ, Soffietti R, Trevisan E, Ruda R, Bertero L, Bosa C, Fabrini MG, Lolli I, Jalali R, Julka PK, Anand AK, Bhavsar D, Singhal N, Naik R, John S, Mathew BS, Thaipisuttikul I, Graber J, DeAngelis LM, Shirinian M, Fontebasso AM, Jacob K, Gerges N, Montpetit A, Nantel A, Albrecht S, Jabado N, Mammoser AG, Shah K, Conrad CA, Di K, Linskey M, Bota DA, Thon N, Eigenbrod S, Kreth S, Lutz J, Tonn JC, Kretzschmar H, Peraud A, Kreth FW, Muggeri AD, Alderuccio JP, Diez BD, Jiang P, Chao Y, Gallagher M, Kim R, Pastorino S, Fogal V, Kesari S, Rudnick JD, Bresee C, Rogatko A, Sakowsky S, Franco M, Hu J, Lim S, Lopez A, Yu L, Ryback K, Tsang V, Lill M, Steinberg A, Sheth R, Grimm S, Helenowski I, Rademaker A, Raizer J, Nunes FP, Merker V, Jennings D, Caruso P, Muzikansky A, Stemmer-Rachamimov A, Plotkin S, Spalding AC, Vitaz TW, Sun DA, Parsons S, Welch MR, Omuro A, DeAngelis LM, Omuro A, Beal K, Correa D, Chan T, DeAngelis L, Gavrilovic I, Nolan C, Hormigo A, Lassman AB, Kaley T, Mellinghoff I, Grommes C, Panageas K, Reiner A, Barradas R, Abrey L, Gutin P, Lee SY, Slagle-Webb B, Glantz MJ, Sheehan JM, Connor JR, Schlimper CA, Schlag H, Stoffels G, Weber F, Krueger DA, Care MM, Holland K, Agricola K, Tudor C, Byars A, Sahmoud T, Franz DN, Raizer J, Rice L, Rademaker A, Chandler J, Levy R, Muro K, Grimm S, Nayak L, Iwamoto FM, Rudnick JD, Norden AD, Omuro A, Kaley TJ, Thomas AA, Fadul CE, Meyer LP, Lallana EC, Colman H, Gilbert M, Alfred Yung WK, Aldape K, De Groot J, Conrad C, Levin V, Groves M, Loghin M, Chris P, Puduvalli V, Nagpal S, Feroze A, Recht L, Rangarajan HG, Kieran MW, Scott RM, Lew SM, Firat SY, Segura AD, Jogal SA, Kumthekar PU, Grimm SA, Avram M, Patel J, Kaklamani V, McCarthy K, Cianfrocca M, Gradishar W, Mulcahy M, Von Roenn J, Helenowski I, Rademaker A, Raizer J, Galanis E, Anderson SK, Lafky JM, Kaufmann TJ, Uhm JH, Giannini C, Kumar SK, Northfelt DW, Flynn PJ, Jaeckle KA, Buckner JC, Omar AI, Panageas KS, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL, Eichler AF, Louis DN, Paleologos NA, Fisher BJ, Ashby LS, Cairncross JG, Roldan GB, Wen PY, Ligon KL, Schiff D, Robins HI, Rocque BG, Chamberlain MC, Mason WP, Weaver SA, Green RM, Kamar FG, Abrey LE, DeAngelis LM, Jhanwar SC, Rosenblum MK, Lassman AB, Delios A, Jakubowski A, DeAngelis L, Grommes C, Lassman AB, Theeler BJ, Melguizo-Gavilanes I, Shonka NA, Qiao W, Wang X, Mahajan A, Puduvalli V, Hashemi-Sadraei N, Bawa H, Rahmathulla G, Patel M, Elson P, Stevens G, Peereboom D, Vogelbaum M, Weil R, Barnett G, Ahluwalia MS, Alvord EC, Rockne RC, Rockhill JK, Mrugala MM, Rostomily R, Lai A, Cloughesy T, Wardlaw J, Spence AM, Swanson KR, Zadeh G, Alahmadi H, Wilson J, Gentili F, Lassman AB, Wang M, Gilbert MR, Aldape KD, Beumer JJ, Wright J, Takebe N, Puduvalli VK, Hormigo A, Gaur R, Werner-Wasik M, Mehta MP, Gupta AJ, Campos-Gines A, Le K, Arango C, Richards M, Landeros M, Juan H, Chang JH, Kim JS, Cho JH, Seo CO, Baldock AL, Rockne R, Canoll P, Born D, Yagle K, Swanson KR, Alexandru D, Bota D, Linskey ME, Nabeel S, Raval SN, Raizer J, Grimm S, Rice L, Rosenow J, Levy R, Bredel M, Chandler J, New PZ, Plotkin SR, Supko JG, Curry WT, Chi AS, Gerstner ER, Stemmer-Rachamimov A, Batchelor TT, Ahluwalia MS, Hashemi N, Rahmathulla G, Patel M, Chao ST, Peereboom D, Weil RJ, Suh JH, Vogelbaum MA, Stevens GH, Barnett GH, Corwin D, Holdsworth C, Stewart R, Rockne R, Swanson K, Graber JJ, Kaley T, Rockne RC, Anderson AR, Swanson KR, Jeyapalan S, Goldman M, Boxerman J, Donahue J, Elinzano H, Evans D, O'Connor B, Puthawala MY, Oyelese A, Cielo D, Blitstein M, Dargush M, Santaniello A, Constantinou M, DiPetrillo T, Safran H, Plotkin SR, Halpin C, Merker V, Barker FG, Maher EA, Ganji S, DeBerardinis R, Hatanpaa K, Rakheja D, Yang XL, Mashimo T, Raisanen J, Madden C, Mickey B, Malloy C, Bachoo R, Choi C, Ranjan T, Yono N, Zalatimo O, Zoccoli C, Glantz M, Han SJ, Sun M, Berger MS, Aghi M, Gupta N, Parsa AT. MEDICAL AND NEURO-ONCOLOGY. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Erickson BJ, Wood CP, Kaufmann TJ, Patriarche JW, Mandrekar J. Optimal presentation modes for detecting brain tumor progression. AJNR Am J Neuroradiol 2011; 32:1652-7. [PMID: 21852368 DOI: 10.3174/ajnr.a2596] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE A common task in radiology interpretation is visual comparison of images. The purpose of this study was to compare traditional side-by-side and in-place (flicker) image presentation modes with advanced methods for detecting primary brain tumors on MR imaging. MATERIALS AND METHODS We identified 66 patients with gliomas and 3 consecutive brain MR imaging examinations (a "triplet"). A display application that presented images in side-by-side mode with or without flicker display as well as display of image subtraction or automated change detection information (also with and without flicker display) was used by 3 board-certified neuroradiologists. They identified regions of brain tumor progression by using this display application. Each case was reviewed using all modes (side-by-side presentation with and without flicker, subtraction with and without flicker, and change detection with and without flicker), with results compared via a panel rating. RESULTS Automated change detection with or without flicker (P < .0027) as well as subtraction with or without flicker (P < .0027) were more sensitive to tumor progression than side-by-side presentation in cases where all 3 raters agreed. Change detection afforded the highest interrater agreement, followed by subtraction. Clinically determined time to progression was longer for cases rated as nonprogressing by using subtraction images and change-detection images both with and without flicker display mode compared with side-by-side presentation. CONCLUSIONS Automated change detection and image subtraction, with and without flicker display mode, are superior to side-by-side image comparison.
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Affiliation(s)
- B J Erickson
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
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Galanis E, Jaeckle KA, Anderson S, Kaufmann TJ, Uhm JH, Giannini C, Kumar S, Northfelt DW, Flynn PJ, Buckner JC. NCCTG phase II trial of bevacizumab in combination with sorafenib in recurrent GBM. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.2018] [Citation(s) in RCA: 3] [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: 11/20/2022] Open
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Kaufmann TJ, Huston J, Cloft HJ, Mandrekar J, Gray L, Bernstein MA, Atkinson JL, Kallmes DF. A prospective trial of 3T and 1.5T time-of-flight and contrast-enhanced MR angiography in the follow-up of coiled intracranial aneurysms. AJNR Am J Neuroradiol 2009; 31:912-8. [PMID: 20019107 DOI: 10.3174/ajnr.a1932] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Endovascularly coiled intracranial aneurysms are increasingly being followed up with noninvasive MRA imaging to evaluate for aneurysm recurrences. It has not been well-established which MRA techniques are best for this application, however. Our aim was to prospectively compare 4 MRA techniques, TOF and CE-MRA at 1.5T and 3T, to a reference standard of DSA in the evaluation of previously endovascularly coiled intracranial aneurysms. MATERIALS AND METHODS Fifty-eight subjects with 63 previously coiled intracranial aneurysms underwent all 4 MRA techniques within 8 days of DSA. There were 2 outcome variables: coil occlusion class (class 1, complete; class 2, dog ear; class 3, residual neck; class 4, aneurysm filling) and change in degree of occlusion since the previous comparison. Sensitivity and specificity were computed for each MRA technique relative to the reference standard of DSA. Differences among the MRA techniques were evaluated in pair-wise fashion by using the McNemar test. RESULTS For the detection of any aneurysm remnant, the sensitivity was 85%-90% for all MRA techniques. Sensitivity dropped to 50%-67% when calculated for the detection of only the class 3 and 4 aneurysm remnants, because several class 3 and 4 remnants were misclassified as class 2 by MRA. CE-MRA at 1.5T and 3T misclassified fewer of the class 3 and 4 remnants than did TOF-MRA at 1.5T, as reflected by the significantly greater sensitivity for larger aneurysm remnants with CE-MRA relative to TOF-MRA at 1.5T (P = .0455 for both comparisons). CONCLUSIONS CE-MRA is more likely than TOF-MRA to classify larger aneurysm remnants appropriately. We recommend performing both CE-MRA and TOF-MRA in the follow-up of coiled intracranial aneurysms and at 3T if available.
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Affiliation(s)
- T J Kaufmann
- Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA.
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Aadland TD, Thielen KR, Kaufmann TJ, Morris JM, Lanzino G, Kallmes DF, Schueler BA, Cloft H. 3D C-arm conebeam CT angiography as an adjunct in the precise anatomic characterization of spinal dural arteriovenous fistulas. AJNR Am J Neuroradiol 2009; 31:476-80. [PMID: 19850761 DOI: 10.3174/ajnr.a1840] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Precise anatomic understanding of the vascular anatomy of SDAVFs is required before treatment. This study demonstrates the utility of C-arm conebeam CT to locate precisely the fistulous point in SDAVFs and the courses of their feeding arteries and draining veins. MATERIALS AND METHODS This retrospective study reports 14 consecutive patients with SDAVFs who underwent DSA and C-arm conebeam CT angiography. SDAVF sites included 5 thoracic, 7 lumbar, and 2 sacral fistulas. Selective DSA initially identified the location and arterial supply of the SDAVF. C-arm conebeam CT angiography was then performed with selective injection into the feeding artery. Reconstructed images were reviewed at a workstation with the referring surgeon, in conjunction with the standard 2D DSA images. The value of C-arm conebeam CT in depicting the fistula and the relationship to adjacent structures was qualitatively assessed. RESULTS In all 14 patients, C-arm conebeam CT angiography was technically successful and precisely demonstrated the site of the fistula, feeding arteries, draining veins, and the relationship of the fistula to adjacent osseous structures. Information obtained from the C-arm conebeam CT angiogram was considered useful in all surgically (12 patients) and endovascularly (2 patients) treated SDAVFs. CONCLUSIONS 3D C-arm conebeam CT angiography is a useful adjunct to 2D DSA in the anatomic characterization of SDAVFs. The technique allowed improved visualization of the vascular anatomy of the SDAVFs and clearer definition of their spatial relationships to adjacent structures.
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Affiliation(s)
- T D Aadland
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
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Gray LA, Rad AE, Gaughen JR, Kaufmann TJ, Kallmes DF. Efficacy of percutaneous vertebroplasty for multiple synchronous and metachronous vertebral compression fractures. AJNR Am J Neuroradiol 2009; 30:318-22. [PMID: 18854440 DOI: 10.3174/ajnr.a1328] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [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: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Limited data exists regarding the efficacy of percutaneous vertebroplasty for multiple synchronous and metachronous vertebral compression fractures. The purpose of this study was to evaluate whether the number of vertebral levels treated during percutaneous vertebroplasty procedures or the number of separate vertebroplasty procedures performed on a given patient affect clinical outcomes. MATERIALS AND METHODS We defined 3 patient populations in our retrospective study. Group 1 included 328 patients who underwent 1 single-level vertebroplasty procedure. Group 2 included 226 patients who underwent a single procedure in which 2 or more vertebral levels were treated. Group 3 included 101 patients who underwent 2 or more separate vertebroplasty procedures. Follow-up was performed between 1 week and 2 years postoperatively. Clinical outcomes were assessed through analysis of quantitative measurements of pre- and postoperative levels of pain with and without activity (0-10) as well as mobility improvement. The Kruskal-Wallis rank sum test was used to evaluate the differences among groups. Univariate and chi(2) analyses were performed to show the proportion of underlying diseases in each group. RESULTS Mean pain improvement with/without activity at 2-year follow-up was 5.8/3, 4.9/3.7, and 5.4/3.1 in groups 1, 2, and 3, respectively; and mean mobility improvement in 2-year follow-up was 0.67, 0.63, and 0.65 for groups 1, 2, and 3, respectively. CONCLUSIONS There was no significant difference in pain relief and mobility improvement in patients treated for multiple synchronous or metachronous vertebral compression fractures in comparison with those treated for solitary isolated fractures.
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Affiliation(s)
- L A Gray
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
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Layton KF, Kallmes DF, Kaufmann TJ. Use of the ulnar artery as an alternative access site for cerebral angiography. AJNR Am J Neuroradiol 2006; 27:2073-4. [PMID: 17110669 PMCID: PMC7977203] [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: 05/12/2023]
Abstract
Although the common femoral artery is the easiest and most widely accepted access site for cerebral angiography, atherosclerotic, aortoiliac, or femoral artery disease can preclude this approach. We describe our experience using the ulnar artery access site in a patient with bilateral aortoiliac occlusive disease. This article may be useful to neuroradiologists who encounter difficulty with other arterial access sites. A description of the technique and a review of the pertinent literature are provided.
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Affiliation(s)
- K F Layton
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.
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Kaufmann TJ, Trout AT, Kallmes DF. The effects of cement volume on clinical outcomes of percutaneous vertebroplasty. AJNR Am J Neuroradiol 2006; 27:1933-7. [PMID: 17032870 PMCID: PMC7977919] [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: 05/12/2023]
Abstract
BACKGROUND AND PURPOSE There exists significant variability in the volume of polymethylmethacrylate cement injected during percutaneous vertebroplasty. Larger cement volumes injected may be associated with better clinical outcomes, but larger volumes may also be associated with greater risk of complications related to cement leakage. We describe an analysis of the association between clinical and procedural variables, including cement volume injected, and the clinical outcomes of patients treated with single-level vertebroplasty. METHODS Retrospective analysis of 158 patients treated with single-level vertebroplasty was performed. Relationships among patient and procedural variables and relationships between these variables and ordinal clinical outcome scores of pain and medication use at postprocedure time points from 1 week to 2 years were evaluated with bivariate and multivariable analyses. RESULTS There was no significant association between the volume of cement injected and the clinical outcomes of postprocedure pain (P = .159-.871) and medication use (P = .223-.875). CONCLUSION Vertebroplasty operators need not feel compelled to achieve particular cement volumes injected in the pursuit of better clinical outcomes but should strive to achieve the maximal safe filling of individual vertebral bodies.
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Affiliation(s)
- T J Kaufmann
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA.
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Kaufmann TJ, Marx WF, Kallmes DF. A failure of matrix metalloproteinase inhibition in the prevention of rat intracranial aneurysm formation. Neuroradiology 2006; 48:190-5. [PMID: 16391918 DOI: 10.1007/s00234-005-0025-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2005] [Accepted: 10/08/2005] [Indexed: 10/25/2022]
Abstract
We tested the hypothesis that nonspecific matrix metalloproteinase (MMP) inhibition with doxycycline would decrease the incidence of intracranial aneurysm formation in a rat aneurysm model. We performed common carotid artery ligation on 96 Long-Evans rats. A treatment group of 48 animals was chosen at random to receive oral doxycycline (3 mg/kg) in addition to standard rat chow, and the control group of 48 animals received standard rat chow only. The major circle of Willis arteries was dissected at 1 year following carotid ligation, and the proportions of animals with aneurysms were compared between groups using Fisher's exact test. Four animals given oral doxycycline and ten control animals expired before 1 year. Of the examined animals, eight saccular intracranial aneurysms were found in 8 of 45 animals which had received doxycycline (17.8%) and seven saccular intracranial aneurysms were found in 7 of 37 control animals (18.9%). There was no significant difference in aneurysm formation between the doxycycline-treated and control groups (P=0.894). Nonspecific MMP inhibition with doxycycline is not effective in preventing intracranial aneurysm formation in a rat model.
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Affiliation(s)
- T J Kaufmann
- Department of Radiology, Mayo Clinic and Foundation, Mayo Building, E2, Rochester, MN 55905, USA.
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Trout AT, Kallmes DF, Kaufmann TJ. New fractures after vertebroplasty: adjacent fractures occur significantly sooner. AJNR Am J Neuroradiol 2006; 27:217-23. [PMID: 16418388 PMCID: PMC7976057] [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: 05/06/2023]
Abstract
BACKGROUND AND PURPOSE Whether vertebroplasty increases the risk of adjacent-level vertebral fractures remains uncertain. Biomechanical and clinical studies suggest an increased risk, but compelling data have not yet been put forth to settle this difficult issue. We believe that an analysis of the time interval between vertebroplasty and subsequent fractures may shed additional light on this debate. We specifically hypothesized that subsequent fractures would occur sooner and more frequently in the vertebrae adjacent to the treated level. METHODS We performed a retrospective analysis of the risk and timing of subsequent fractures in patients previously treated with vertebroplasty. Multiple linear regression was used to explore factors that influence the time to new fracture following vertebroplasty. Fractures were then divided on the basis of whether they occurred adjacent or non-adjacent to the treated level. Survival analysis was used to compare time to new fracture among the 2 groups, and the relative risk of both types of fracture was calculated. RESULTS In this study, 186 new vertebral fractures occurred in 86 (19.9%) of 432 patients. Seventy-seven (41.4%) fractures were of vertebrae adjacent to the level treated with vertebroplasty. Median times until diagnosis of new adjacent and non-adjacent level fractures were 55 days and 127 days, respectively. Time to fracture was significantly different between the 2 groups (logrank <0.0001). Distance of the new fracture from the treated level was also significantly associated with time to new fracture (P < .0001). Relative risk of adjacent level fracture was 4.62 times that for non-adjacent level fracture. CONCLUSION These data demonstrate an association between vertebroplasty and new vertebral fractures. Specifically, following vertebroplasty, patients are at increased risk of new-onset adjacent-level fractures and, when these fractures occur, they occur sooner than non-adjacent level fractures.
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Affiliation(s)
- A T Trout
- Mayo Clinic College of Medicine, Rochester, MN 55905, USA
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Kaufmann TJ, Jensen ME, Schweickert PA, Marx WF, Kallmes DF. Age of fracture and clinical outcomes of percutaneous vertebroplasty. AJNR Am J Neuroradiol 2001; 22:1860-3. [PMID: 11733316 PMCID: PMC7973855] [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: 02/22/2023]
Abstract
BACKGROUND AND PURPOSE The patient populations that are most likely to benefit from percutaneous vertebroplasty (PVP) are uncertain. Our purpose was to evaluate the effect of the age of vertebral compression fracture (VCF) on clinical improvement after PVP. METHODS We performed a retrospective review of charts of patients who had undergone PVP for painful osteoporotic VCFs at our institution. The preprocedural and postprocedural outcome measurements of pain, mobility, and analgesic use were compared for 80 treatment sessions in 75 patients (122 total vertebrae treated). We assessed the association between the duration of pain before PVP and postprocedural outcomes by using multivariable analysis. RESULTS Age of fracture at time of PVP was not independently associated with postprocedural pain or activity. Increasing age of fracture was independently associated with slightly greater postprocedural analgesic requirement, at least for patients who required narcotics at baseline before PVP. Greater preprocedural analgesic requirement was independently associated with greater postprocedural analgesic requirement. Reduced preprocedural mobility was independently associated with reduced postprocedural mobility. CONCLUSION PVP is a highly efficacious therapy for relief of pain and improvement in mobility, regardless of fracture age. PVP also is efficacious in reducing analgesic requirement, although this effect may be slightly blunted in patients who require narcotics before the procedure and in those who have older fractures.
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Affiliation(s)
- T J Kaufmann
- Department of Radiology, University of Virginia Health Services, Charlottesville 22908, USA
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Bellavia D, Schneider PM, Rittner C, Malfitano G, Kaufmann TJ, Brai M. Detection of heterozygous C8 beta deficiency by PCR in a healthy Italian population. Exp Clin Immunogenet 1996; 13:173-80. [PMID: 9165271] [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] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In Italy a rather high number of homozygotes with late complement component defects has been found among patients with meningococcal disease. It seems that clinical manifestations of meningococcal disease are less severe in patients with complement deficiency than in normal individuals. This situation could even be more evident in the heterozygous carriers for whom a selective advantage is discussed. In this study we have screened a cohort of 527 Italian blood donors from western Sicily for the presence of C8B mutated allele. Heterozygotes for C8 beta deficiency were identified using a specific PCR assay to detect a C-->T transition in exon 9 of the C8B gene. This mutation represents the most frequent genetic mechanism for C8 beta deficiency in Caucasians. A rapid PCR screening test was performed on DNA extracted from pooled blood samples of up to 8 individuals. A single male individual with heterozygous C8 beta deficiency was detected. In the family studies it was shown that his two brothers and the mother were heterozygous carriers too. Functional activity of the classical and alternative complement pathways were normal. No neisserial infections or inflammatory diseases were found in the family history. It was shown that the allele-specific PCR is a sensitive and rapid method to examine large numbers of DNA samples. It permitted to assess the real prevalence of the C8B mutated null allele in the general population free of ascertainment bias.
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Affiliation(s)
- D Bellavia
- Institute of General Pathology, University of Palermo, Italy
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Barba GM, Kaufmann TJ, Schneider PM, Rittner C, Brai M. Polymorphism of the complement C8A and -B genes in two families with C8 beta deficiency and neisserial infections. Clin Immunol Immunopathol 1994; 72:83-9. [PMID: 8020197 DOI: 10.1006/clin.1994.1110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Serum samples from members of two Italian families with complement C8 beta deficiency were studied by SDS-PAGE under nonreducing conditions and by IEF. The proband of family I had suffered from two episodes of purulent meningitis and two of her uncles had suffered from only one episode, while the proband of family II had suffered from three different episodes. In contrast to previous findings, where C8 beta deficiency was cosegregating with C8A (alpha-gamma) allotype A, the proband of family II had the C8A allotype B. In addition, in one of her sons a novel variant of the C8 beta chain was detected. Studies at the DNA level in family I, using a recently described PCR system, demonstrate the presence of a C-T exchange, which creates a stop codon in exon 9 of the C8B gene, as cause for the C8 beta deficiency. The mutated allele does not carry the TaqI polymorphic restriction site located in intron 11 of the C8B gene. These findings provide evidence for multiple recombination events within the genetic region of the defective C8B gene.
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Affiliation(s)
- G M Barba
- Institute for Legal Medicine, Johannes Gutenberg University, Mainz, Germany
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