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Mijaljevic MB, Milosevic ZC, Lavrnic SĐ, Jokovic ZM, Ninkovic DI, Tubic RM, Jankovic RR. Assessment of chemical-shift and diffusion-weighted magnetic resonance imaging in differentiating malignant and benign vertebral lesions in oncologic patients. A single institution experience. Radiol Oncol 2024; 58:527-534. [PMID: 39361940 PMCID: PMC11604263 DOI: 10.2478/raon-2024-0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 07/25/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND To analyze the contribution of two non-standard magnetic resonance imaging (MRI) techniques the chemical-shift image (CSI), and diffusion-weighted imaging (DWI) in distinguishing malignant and benign vertebral bone marrow lesions (VBMLs). PATIENTS AND METHODS Conventional spine MRI protocol, followed by CSI and DWI was performed with a 1.5 T system on 102 oncologic patients between January 2020 and December 2023. From the identified 325 VBMLs, 102 representative lesions (one per patient) were selected. VBMLs were divided into malignant (n = 74) and benign (n = 28) based on histopathology, or imaging follow-up. The quantitative parameters for VBMLs assessment were signal intensity ratio (SIR) derived from CSI and apparent diffusion coefficient (ADC) derived from DWI. RESULTS The malignant VBMLs had significantly higher SIR values (p < 0.05) and lower ADC values compared to benign VBMLs (p < 0.05). The area under the curve (AUC) was 0.953 (p < 0.001) for SIR, and 0.894 for ADC (p < 0.001) (cut-off at > 0.82, and ≤ 1.57x10-3 mm2/s, respectively). The sensitivity and specificity for SIR were 93.6%, and 88.5%, while for ADC were 88.2% and 92.3% (respectively). The combined use of SIR and ADC improved the diagnostic accuracy to AUC of 0.988 (p < 0.001, cut-off at > 0.19), sensitivity, and specificity of 100.0% and 90.9% (respectively). CONCLUSIONS Quantitative parameters, SIR and ADC, derived from two non-standard MRI techniques, CSI, and DWI, showed diagnostic strength in differentiating malignant and benign VBMLs. Combining both methods can further enhance the diagnostic performance and accuracy of spine MRI in clinical practice.
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Affiliation(s)
- Marija B Mijaljevic
- Department of Radiology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | | | - Slobodan Đ Lavrnic
- Department of Radiology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Zorica M Jokovic
- Department of Radiology, University Children's Hospital, Belgrade, Serbia
| | - Danica I Ninkovic
- Department of Radiology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Radoje M Tubic
- Department of Radiology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | - Rajna R Jankovic
- Department of Radiology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
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Vihtelic P, Skuk E, Suster NK, Stefanovska MJ, Popovic P. Emergency and prophylactic uterine artery embolization in gynecology and obstetrics - a retrospective analysis. Radiol Oncol 2024; 58:397-405. [PMID: 39287170 PMCID: PMC11406928 DOI: 10.2478/raon-2024-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/21/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND This study aimed to evaluate the safety and efficacy of emergency and prophylactic uterine artery embolization (UAE) in our clinical practice, including technical success, clinical success, and associated complications. PATIENTS AND METHODS In this retrospective study, we analyzed 64 women who underwent emergency (n =18) and prophylactic (n = 46) UAE. Indications for emergency UAE included postpartum hemorrhage or severe hemorrhage during pregnancy termination, while prophylactic UAE was performed prior to surgical removal of retained products of conception (RPOC), delivery with abnormal placental implantation, or pregnancy termination (cervical pregnancy or fetal anomalies accompanied by abnormal placental implantation). Technical success of UAE was defined as complete exclusion of the vascular lesion and contrast stasis on the final angiogram, while clinical success was defined as cessation of bleeding after UAE Termination without a hysterectomy. RESULTS The overall clinical success of UAE in our study was 97% (62/64). All embolization procedures were technically and clinically successful in the prophylactic group without life-threatening hemorrhages or hysterectomies (100% success rate, 46/46). However, while 100% technical success was similarly attained in the emergency group, bleeding was successfully controlled in 89% of cases (16/18). In two patients with significant blood loss (over 2000 mL), embolization failed to achieve hemostasis, resulting in persistent bleeding and subsequent hysterectomy. CONCLUSIONS UAE is a safe and effective procedure for managing primary postpartum hemorrhage or severe hemorrhage during pregnancy termination and for decreasing the risk of severe hemorrhage during surgical removal of RPOC, delivery with abnormal placental implantation, or pregnancy.
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Affiliation(s)
- Polona Vihtelic
- Clinical Institute of Radiology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Eva Skuk
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Natasa Kenda Suster
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Marina Jakimovska Stefanovska
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Peter Popovic
- Clinical Institute of Radiology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Antoniou A, Nikolaou A, Evripidou N, Georgiou A, Filippou A, Zinonos V, Giannakou M, Chrysanthou A, Ioannides C, Damianou C. Phantom-based assessment of motion and needle targeting accuracy of robotic devices for magnetic resonance imaging-guided needle biopsy. Int J Med Robot 2023; 19:e2526. [PMID: 37165718 DOI: 10.1002/rcs.2526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND The current study proposes simple methods for assessing the performance of robotic devices intended for Magnetic Resonance Imaging (MRI)-guided needle biopsy. METHODS In-house made agar-based breast phantoms containing biopsy targets served as the main tool in the evaluation process of an MRI compatible positioning device comprising a needle navigator. The motion accuracy of mechanical stages was assessed by calliper measurements. Laboratory evaluation of needle targeting included a repeatability phantom test and a laser-based method. The accuracy and repeatability of needle targeting was also assessed by MRI. RESULTS The maximum error of linear motion for steps up to 10 mm was 0.1 mm. Needle navigation relative to the phantom and alignment with the various biopsy targets were performed successfully in both the laboratory and MRI settings. The proposed biopsy phantoms offered tissue-like signal in MRI and good haptic feedback during needle insertion. CONCLUSIONS The proposed methods could be valuable in the process of validating the accuracy of MRI-guided biopsy robotic devices in both laboratory and real environments.
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Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Anastasia Nikolaou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Nikolas Evripidou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Andreas Georgiou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Antria Filippou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Vasiliki Zinonos
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | | | - Antreas Chrysanthou
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | - Cleanthis Ioannides
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
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Long-term complications of systemic oxalosis in children-a retrospective single-center cohort study. Pediatr Nephrol 2021; 36:3123-3132. [PMID: 33651179 DOI: 10.1007/s00467-021-05002-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/18/2021] [Accepted: 02/11/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Systemic oxalosis is a severe complication seen in primary hyperoxaluria type I patients with kidney failure. Deposition of insoluble calcium oxalate crystals in multiple organs leads to significant morbidity and mortality. METHODS We describe a retrospective cohort of 11 patients with systemic oxalosis treated at our dialysis unit from 1982 to 1998 (group 1) and 2007-2019 (group 2). Clinical and demographic data were collected from medical records. Imaging studies were only available for patients in group 2 (n = 5). RESULTS Median age at dialysis initiation was 6.1 months (IQR 4-21.6), 64% were male. Dialysis modality was mostly peritoneal dialysis in group 1 and daily hemodialysis in group 2. Bone disease was the first manifestation of systemic oxalosis, starting with the appearance of sclerotic bands (mean 166 days, range 1-235), followed by pathological fractures in long bones (mean 200.4 days, range 173-235 days). Advanced disease was characterized by vertebral fractures with resulting kyphosis, worsening splenomegaly, and adynamic bone disease. Two patients developed pulmonary hypertension, 4 and 8 months prior to their death. Four of 11 patients developed hypothyroidism 0-60 months after dialysis initiation. Only one patient survived after a successful liver-kidney transplantation. Four patients died after liver or liver-kidney transplantation. CONCLUSIONS This is the first comprehensive description of the natural history of pediatric systemic oxalosis. We hope that our findings will provide basis for a quantitative severity score in future, larger studies.
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Dynamic evaluation of lung involvement during coronavirus disease-2019 (COVID-19) with quantitative lung CT. Emerg Radiol 2020; 27:671-678. [PMID: 33037946 PMCID: PMC7547301 DOI: 10.1007/s10140-020-01856-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 09/24/2020] [Indexed: 12/23/2022]
Abstract
Purpose To identify and quantify lung changes associated with coronavirus disease-2019 (COVID-19) with quantitative lung CT during the disease. Methods This retrospective study reviewed COVID-19 patients who underwent multiple chest CT scans during their disease course. Quantitative lung CT was used to determine the nature and volume of lung involvement. A semi-quantitative scoring system was also used to evaluate lung lesions. Results This study included eighteen cases (4 cases in mild type, 10 cases in moderate type, 4 cases in severe type, and without critical type cases) with confirmed COVID-19. Patients had a mean hospitalized period of 24.1 ± 7.1 days (range: 14–38 days) and underwent an average CT scans of 3.9 ± 1.6 (range: 2–8). The total volumes of lung abnormalities reached a peak of 8.8 ± 4.1 days (range: 2–14 days). The ground-glass opacity (GGO) volume percentage was higher than the consolidative opacity (CO) volume percentage on the first CT examination (Z = 2.229, P = 0.026), and there was no significant difference between the GGO volume percentage and that of CO at the peak stage (Z = - 0.628, P = 0.53). The volume percentage of lung involvement identified by AI demonstrated a strong correlation with the total CT scores at each stage (r = 0.873, P = 0.0001). Conclusions Quantitative lung CT can automatically identify the nature of lung involvement and quantify the dynamic changes of lung lesions on CT during COVID-19. For patients who recovered from COVID-19, GGO was the predominant imaging feature on the initial CT scan, while GGO and CO were the main appearances at peak stage. Electronic supplementary material The online version of this article (10.1007/s10140-020-01856-4) contains supplementary material, which is available to authorized users.
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Yu C, Li T, Zhang R, Yang X, Yang Z, Xin L, Zhao Z. Dual-energy CT perfusion imaging for differentiating WHO subtypes of thymic epithelial tumors. Sci Rep 2020; 10:5511. [PMID: 32218504 PMCID: PMC7098982 DOI: 10.1038/s41598-020-62466-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 03/13/2020] [Indexed: 11/09/2022] Open
Abstract
To evaluate the role of conventional contrast-enhanced CT (CECT) imaging and dual-energy spectral CT (DECT) perfusion imaging in differentiating the WHO histological subtypes of thymic epithelial tumours (TETs). Eighty-eight patients with TETs who underwent DECT perfusion scans (n = 51) and conventional CT enhancement scans (n = 37) using a GE Discovery CT750 HD scanner were enrolled in this study. The mean maximal contrast-enhanced range (mean CEmax) and the perfusion and spectral parameters of the lesions were analysed. Among the six WHO subtypes (Type A, AB, B1, B2, and B3 thymoma and thymic carcinoma), the mean CEmax values and most of the perfusion and spectral parameter values of Type A and Type AB were significantly higher than those of the other subtypes (all P < 0.05), and there was no difference among Type B1, B2 and B3 (all P > 0.05). The mean CEmax value was not different between Type B (including Type B1, B2, and B3) and thymic carcinoma (P = 1.000). The PS, IC, NIC and λHU values in the optimal venous phase of thymic carcinoma were higher than those of Type B (all P < 0.05). The parameters of conventional CECT imaging and DECT perfusion imaging can help identify the subtype of TETs, especially those of DECT perfusion imaging in type B thymomas and thymic carcinomas.
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Affiliation(s)
- Chunhai Yu
- Imaging Department, Shanxi Tumor Hospital, The Affiliated Tumor Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030013, P.R. China
| | - Ting Li
- Department of Nephrology, Taiyuan People's Hospital, Taiyuan, Shanxi, 030001, P.R. China
| | - Ruiping Zhang
- Imaging Department, Shanxi Tumor Hospital, The Affiliated Tumor Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030013, P.R. China.
| | - Xiaotang Yang
- Imaging Department, Shanxi Tumor Hospital, The Affiliated Tumor Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030013, P.R. China
| | - Zhao Yang
- Imaging Department, Shanxi Tumor Hospital, The Affiliated Tumor Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030013, P.R. China
| | - Lei Xin
- Imaging Department, Shanxi Tumor Hospital, The Affiliated Tumor Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030013, P.R. China
| | - Zhikai Zhao
- Imaging Department, Shanxi Tumor Hospital, The Affiliated Tumor Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030013, P.R. China
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Wu F. High intensity focused ultrasound: A noninvasive therapy for locally advanced pancreatic cancer. World J Gastroenterol 2014; 20:16480-16488. [PMID: 25469016 PMCID: PMC4248191 DOI: 10.3748/wjg.v20.i44.16480] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 07/08/2014] [Accepted: 08/28/2014] [Indexed: 02/06/2023] Open
Abstract
The noninvasive ablation of pancreatic cancer with high intensity focused ultrasound (HIFU) energy is received increasingly widespread interest. With rapidly temperature rise to cytotoxic levels within the focal volume of ultrasound beams, HIFU can selectively ablate a targeted lesion of the pancreas without any damage to surrounding or overlying tissues. Preliminary studies suggest that this approach is technical safe and feasible, and can be used alone or in combination with systemic chemotherapy for the treatment of patients with locally advanced pancreatic cancer. It can effectively alleviate cancer-related abdominal pain, and may confer an additional survival benefit with few significant complications. This review provides a brief overview of HIFU, describes current clinical applications, summarizes characteristics of continuous and pulsed HIFU, and discusses future applications and challenges in the treatment of pancreatic cancer.
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Lim D, Lee SY, Lim KH, Chan CY. Hepatic adenoma mimicking a metastatic lesion on computed tomography-positron emission tomography scan. World J Gastroenterol 2013; 19:4432-4436. [PMID: 23885159 PMCID: PMC3718916 DOI: 10.3748/wjg.v19.i27.4432] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 05/15/2013] [Accepted: 06/04/2013] [Indexed: 02/06/2023] Open
Abstract
Positron emission tomography (PET) using 18F-fluorodeoxyglucose (18F-FDG) is an imaging modality which reflects cellular glucose metabolism. Most malignant cells accumulate and trap 18F-FDG, allowing the visualisation of increased uptake. It is hence widely used to differentiate malignant from benign lesions. “False positive” findings of hepatic lesions have been described in certain instances such as hepatic abscesses, but are rare in cases involving hepatocellular adenomas. To our knowledge, there have been only 7 reports in the English literature documenting PET-avid hepatocellular adenomas; 6 of the 7 reports were published in the last 3 years with the first report by Patel et al. We report the case of a 44-year-old Chinese female patient with a history of cervical adenocarcinoma, referred for a hepatic lesion noted on a surveillance computed tomography (CT) scan. A subsequent CT-PET performed showed a hypermetabolic lesion (standardized uptake value 7.9) in segment IVb of the liver. After discussion at a multi-disciplinary hepato-pancreato-biliary conference, the consensus was that of a metastatic lesion from her previous cervical adenocarcinoma, and a resection of the hepatic lesion was performed. Histology revealed features consistent with a hepatocyte nuclear factor-1 α inactivated steatotic hepatocellular adenoma.
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