Sample records for clinical 3-tesla imager

  1. Human brain diffusion tensor imaging at submillimeter isotropic resolution on a 3Tesla clinical MRI scanner. (United States)

    Chang, Hing-Chiu; Sundman, Mark; Petit, Laurent; Guhaniyogi, Shayan; Chu, Mei-Lan; Petty, Christopher; Song, Allen W; Chen, Nan-kuei


    The advantages of high-resolution diffusion tensor imaging (DTI) have been demonstrated in a recent post-mortem human brain study (Miller et al., NeuroImage 2011;57(1):167-181), showing that white matter fiber tracts can be much more accurately detected in data at a submillimeter isotropic resolution. To our knowledge, in vivo human brain DTI at a submillimeter isotropic resolution has not been routinely achieved yet because of the difficulty in simultaneously achieving high resolution and high signal-to-noise ratio (SNR) in DTI scans. Here we report a 3D multi-slab interleaved EPI acquisition integrated with multiplexed sensitivity encoded (MUSE) reconstruction, to achieve high-quality, high-SNR and submillimeter isotropic resolution (0.85×0.85×0.85mm(3)) in vivo human brain DTI on a 3Tesla clinical MRI scanner. In agreement with the previously reported post-mortem human brain DTI study, our in vivo data show that the structural connectivity networks of human brains can be mapped more accurately and completely with high-resolution DTI as compared with conventional DTI (e.g., 2×2×2mm(3)).

  2. Imaging Findings of Brain Death on 3-Tesla MRI

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    Sohn, Chul Ho [Dept. of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); Lee, Hwa Pyung [Dept. of Occupational and Environmental Medicine, CHA Gumi Medical Center, CHA University, Gumi (Korea, Republic of); Park, Jun Beom [Dept. of Radiology, Korean Armed Force Daejeon Hospital, Daejeon (Korea, Republic of); Chang, Hyuk Won; Kim, Easlmaan; Park, Ui Jun; Kim, Hyoung Tae [Keimyung University College of Medicine, Dongsan Medical Center, Daegu (Korea, Republic of); Kim, Eun Hee [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Ku, Jeong Hun [Dept. of Biomedical Engineering, Keimyung University College of Medicine, Daegu (Korea, Republic of)


    To demonstrate the usefulness of 3-tesla (3T) magnetic resonance imaging (MRI) including T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), time-of-flight (TOF) magnetic resonance angiography (MRA), T2*-weighted gradient recalled echo (GRE), and susceptibility weighted imaging (SWI) in diagnosing brain death. Magnetic resonance imaging findings for 10 patients with clinically verified brain death (group I) and seven patients with comatose or stuporous mentality who did not meet the clinical criteria of brain death (group II) were retrospectively reviewed. Tonsilar herniation and loss of intraarterial flow signal voids (LIFSV) on T2WI were highly sensitive and specific findings for the diagnosis of brain death (p < 0.001 and < 0.001, respectively). DWI, TOF-MRA, and GRE findings were statistically different between the two groups (p = 0.015, 0.029, and 0.003, respectively). However, cortical high signal intensities in T2WI and SWI findings were not statistically different between the two group (p = 0.412 and 1.0, respectively). T2-weighted imaging, DWI, and MRA using 3T MRI may be useful for diagnosing brain death. However, SWI findings are not specific due to high false positive findings.

  3. Functional and perfusion magnetic resonance imaging at 3 tesla

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    Klarhoefer, M


    This thesis deals with the development and optimization of fast magnetic resonance imaging (MRI) methods for non-invasive functional studies of the human brain and perfusion imaging on a 3 Tesla (T) whole body NMR system. The functional MRI (fMRI) experiments performed showed that single-shot multi-echo EPI and spiral imaging techniques provide fast tools to obtain information about T2* distributions during functional activation in the human brain. Both sequences were found to be useful in the separation of different sources contributing to the functional MR signal like inflow or susceptibility effects in the various vascular environments. An fMRI study dealing with the involvement of prefrontal brain regions in movement preparation lead to inconsistent results. It could not be clarified if these were caused by problems during a spatial normalization process of the individual brains or if the functional paradigm, using very short inter-stimulus intervals, was not suited for the problem investigated. Blood flo...

  4. A systematic review of the utility of 1.5 versus 3 Tesla magnetic resonance brain imaging in clinical practice and research

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    Wardlaw, Joanna M. [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Edinburgh, Division of Clinical Neurosciences, Edinburgh (United Kingdom); Western General Hospital, SINAPSE Collaboration, Brain Research Imaging Centre, Division of Clinical Neurosciences, Edinburgh (United Kingdom); Brindle, Will; Casado, Ana M.; Thomas, Brenda; Morris, Zoe [University of Edinburgh, Division of Clinical Neurosciences, Edinburgh (United Kingdom); Shuler, Kirsten; Henderson, Moira; Munoz Maniega, Susana; Lymer, Katherine; Pernet, Cyril; Tao, Yuehui [Terry; Parikh, Jehill; Royle, Natalie A.; Bastin, Mark E.; Farrall, Andrew; Valdes Hernandez, Maria C. [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Edinburgh, Division of Clinical Neurosciences, Edinburgh (United Kingdom); Macfarlane, Jennifer [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Dundee, Dundee (United Kingdom); Nailon, William [University of Edinburgh, Edinburgh Cancer Centre, Edinburgh (United Kingdom); Ahearn, Trevor [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Aberdeen, Institute of Medical Sciences, Aberdeen (United Kingdom); Mumuni, Abdul Nashirudeen [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Glasgow, Department of Clinical Physics, Glasgow (United Kingdom); Mugruza, Carlos [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Dundee, School of Psychology, Dundee (United Kingdom); McLean, John [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Glasgow, Institute of Neurological Sciences, Glasgow (United Kingdom); Chakirova, Goultchira [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Edinburgh, Division of Psychiatry, Edinburgh (United Kingdom); Simpson, Johanna [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Stirling, Department of Psychology, Stirling (United Kingdom); Stanfield, Andrew C. [University of Edinburgh, Division of Psychiatry, Edinburgh (United Kingdom); Johnston, Harriet [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of St Andrews, Department of Psychology, St Andrews (United Kingdom); De Wilde, Janet [Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh (United Kingdom); University of Edinburgh, Division of Clinical Neurosciences, Edinburgh (United Kingdom); The Higher Education Academy, York (United Kingdom); Weir, Nick [Royal Infirmary of Edinburgh, Department of Medical Physics, Edinburgh (United Kingdom); Collaboration: SINAPSE Collaborative Group


    MRI at 3 T is said to be more accurate than 1.5 T MR, but costs and other practical differences mean that it is unclear which to use. We systematically reviewed studies comparing diagnostic accuracy at 3 T with 1.5 T. We searched MEDLINE, EMBASE and other sources from 1 January 2000 to 22 October 2010 for studies comparing diagnostic accuracy at 1.5 and 3 T in human neuroimaging. We extracted data on methodology, quality criteria, technical factors, subjects, signal-to-noise, diagnostic accuracy and errors according to QUADAS and STARD criteria. Amongst 150 studies (4,500 subjects), most were tiny, compared old 1.5 T with new 3 T technology, and only 22 (15 %) described diagnostic accuracy. The 3 T images were often described as ''crisper'', but we found little evidence of improved diagnosis. Improvements were limited to research applications [functional MRI (fMRI), spectroscopy, automated lesion detection]. Theoretical doubling of the signal-to-noise ratio was not confirmed, mostly being 25 %. Artefacts were worse and acquisitions took slightly longer at 3 T. Objective evidence to guide MRI purchasing decisions and routine diagnostic use is lacking. Rigorous evaluation accuracy and practicalities of diagnostic imaging technologies should be the routine, as for pharmacological interventions, to improve effectiveness of healthcare. (orig.)

  5. Travelling Wave Magnetic Resonance Imaging at 3 Tesla

    CERN Document Server

    Vazquez, F; Marrufo, O; Rodriguez, A O


    Waveguides have been successfully used to generate magnetic resonance images at 7 T with whole-body systems. The bore limits the magnetic resonance signal transmitted because its specific cut-off frequency is greater than the majority of resonant frequencies. This restriction can be overcome by using a parallel-plate waveguide whose cut-off frequency is zero for the transversal electric modes and it can propagate any frequency. To investigate the potential benefits for whole-body imaging at 3 T, we compare numerical simulations at 1.5 T, 3 T, 7 T, and 9 T via the propagation of the parallel-plate waveguide principal mode filled with a cylindrical phantom and two surface coils. B1 mapping was computed to investigate the feasibility of this approach at 3T. The point spread function method was used to measure the imager performance for the traveling-wave magnetic resonance imaging experiment. Human leg images were acquired to experimentally validate this approach. The principal mode shows very little field magni...

  6. Preoperative 3-Tesla Multiparametric Endorectal Magnetic Resonance Imaging Findings and the Odds of Upgrading and Upstaging at Radical Prostatectomy in Men With Clinically Localized Prostate Cancer

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    Hegde, John V. [Harvard Medical School, Boston, Massachusetts (United States); Department of Radiology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Chen, Ming-Hui [Department of Statistics, University of Connecticut, Storrs, Connecticut (United States); Mulkern, Robert V. [Department of Radiology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Department of Radiology, Children' s Hospital Boston, Boston, Massachusetts (United States); Fennessy, Fiona M. [Department of Radiology, Brigham and Women' s Hospital, Boston, Massachusetts (United States); Department of Imaging, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); D' Amico, Anthony V. [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Tempany, Clare M.C., E-mail: [Division of MRI, Department of Radiology, Brigham and Women' s Hospital, Boston, Massachusetts (United States)


    Purpose: To investigate whether 3-T esla (3T) multiparametric endorectal MRI (erMRI) can add information to established predictors regarding occult extraprostatic or high-grade prostate cancer (PC) in men with clinically localized PC. Methods and Materials: At a single academic medical center, this retrospective study's cohort included 118 men with clinically localized PC who underwent 3T multiparametric erMRI followed by radical prostatectomy, from 2008 to 2011. Multivariable logistic regression analyses in all men and in 100 with favorable-risk PC addressed whether erMRI evidence of T3 disease was associated with prostatectomy T3 or Gleason score (GS) 8-10 (in patients with biopsy GS {<=}7) PC, adjusting for age, prostate-specific antigen level, clinical T category, biopsy GS, and percent positive biopsies. Results: The accuracy of erMRI prediction of extracapsular extension and seminal vesicle invasion was 75% and 95%, respectively. For all men, erMRI evidence of a T3 lesion versus T2 was associated with an increased odds of having pT3 disease (adjusted odds ratio [AOR] 4.81, 95% confidence interval [CI] 1.36-16.98, P=.015) and pGS 8-10 (AOR 5.56, 95% CI 1.10-28.18, P=.038). In the favorable-risk population, these results were AOR 4.14 (95% CI 1.03-16.56), P=.045 and AOR 7.71 (95% CI 1.36-43.62), P=.021, respectively. Conclusions: Three-Tesla multiparametric erMRI in men with favorable-risk PC provides information beyond that contained in known preoperative predictors about the presence of occult extraprostatic and/or high-grade PC. If validated in additional studies, this information can be used to counsel men planning to undergo radical prostatectomy or radiation therapy about the possible need for adjuvant radiation therapy or the utility of adding hormone therapy, respectively.

  7. [Examination of upper abdominal region in high spatial resolution diffusion-weighted imaging using 3-Tesla MRI]. (United States)

    Terada, Masaki; Matsushita, Hiroki; Oosugi, Masanori; Inoue, Kazuyasu; Yaegashi, Taku; Anma, Takeshi


    The advantage of the higher signal-to-noise ratio (SNR) of 3-Tesla magnetic resonance imaging (3-Tesla) has the possibility of contributing to the improvement of high spatial resolution without causing image deterioration. In this study, we compared SNR and the apparent diffusion coefficient (ADC) value with 3-Tesla as the condition in the diffusion-weighted image (DWI) parameter of the 1.5-Tesla magnetic resonance imaging (1.5-Tesla) and we examined the high spatial resolution images in the imaging method [respiratory-triggering (RT) method and breath free (BF) method] and artifact (motion and zebra) in the upper abdominal region of DWI at 3-Tesla. We have optimized scan parameters based on phantom and in vivo study. As a result, 3-Tesla was able to obtain about 1.5 times SNR in comparison with the 1.5-Tesla, ADC value had few differences. Moreover, the RT method was effective in correcting the influence of respiratory movement in comparison with the BF method, and image improvement by the effective acquisition of SNR and reduction of the artifact were provided. Thus, DWI of upper abdominal region was a useful sequence for the high spatial resolution in 3-Tesla.

  8. Chemical exchange saturation transfer MR imaging of Parkinson's disease at 3 Tesla

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    Li, Chunmei; Peng, Shuai; Wang, Rui; Chen, Min [Beijing Hospital, Department of Radiology, Beijing (China); Chen, Haibo; Su, Wen [Beijing Hospital, Department of Neurology, Beijing (China); Zhao, Xuna [Peking University, Center for MRI Research and Beijing City Key Lab for Medical Physics and Engineering, Beijing (China); Zhou, Jinyuan [Johns Hopkins University, Department of Radiology, Baltimore, MD (United States)


    To demonstrate the feasibility of using chemical exchange saturation transfer (CEST) imaging to detect Parkinson's disease (PD) in patients at 3 Tesla. Twenty-seven PD patients (17 men and 10 women; age range, 54-77 years) and 22 age-matched normal controls (13 men and 9 women; age range, 55-73 years) were examined on a 3-Tesla MRI system. Magnetization transfer spectra with 31 different frequency offsets (-6 to 6 ppm) were acquired at two transverse slices of the head, including the basal ganglia and midbrain. One-way analysis of variance tests was used to compare the differences in CEST imaging signals between PD patients and normal controls. Total CEST signal between the offsets of 0 and 4 ppm in the substantia nigra was significantly lower in PD patients than in normal controls (P = 0.006), which could be associated with the loss of dopaminergic neurons. Protein-based CEST imaging signals at the offset of 3.5 ppm in the globus pallidus, putamen and caudate were significantly increased in PD patients, compared to normal controls (P < 0.001, P = 0.003, P < 0.001, respectively). CEST imaging signals could potentially serve as imaging biomarkers to aid in the non-invasive molecular diagnosis of PD. (orig.)

  9. Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results

    Directory of Open Access Journals (Sweden)

    Tudisco Cosimo


    Full Text Available Abstract Background Arthroscopic rotator cuff repair has become popular in the last few years because it avoids large skin incisions and deltoid detachment and dysfunction. Earlier arthroscopic single-row (SR repair methods achieved only partial restoration of the original footprint of the tendons of the rotator cuff, while double-row (DR repair methods presented many biomechanical advantages and higher rates of tendon-to-bone healing. However, DR repair failed to demonstrate better clinical results than SR repair in clinical trials. MR imaging at 3 Tesla, especially with intra-articular contrast medium (MRA, showed a better diagnostic performance than 1.5 Tesla in the musculoskeletal setting. The objective of this study was to retrospectively evaluate the clinical and 3 Tesla MRA results in two groups of patients operated on for a medium-sized full-thickness rotator cuff tear with two different techniques. Methods The first group consisted of 20 patients operated on with the SR technique; the second group consisted of 20 patients operated on with the DR technique. All patients were evaluated at a minimum of 3 years after surgery. The primary end point was the re-tear rate at 3 Tesla MRA. The secondary end points were the Constant-Murley Scale (CMS, the Simple Shoulder Test (SST scores, surgical time and implant expense. Results The mean follow-up was 40 months in the SR group and 38.9 months in the DR group. The mean postoperative CMS was 70 in the SR group and 68 in the DR group. The mean SST score was 9.4 in the SR group and 10.1 in the DR group. The re-tear rate was 60% in the SR group and 25% in the DR group. Leakage of the contrast medium was observed in all patients. Conclusions To the best of our knowledge, this is the first report on 3 Tesla MRA in the evaluation of two different techniques of rotator cuff repair. DR repair resulted in a statistically significant lower re-tear rate, with longer surgical time and higher implant

  10. Cortical microinfarcts detected in vivo on 3 tesla MRI : Clinical and radiological correlates

    NARCIS (Netherlands)

    Van Dalen, Jan Willem; Scuric, Eva E M; Van Veluw, Susanne J.; Caan, Matthan W A; Nederveen, Aart J.; Biessels, Geert Jan; Van Gool, Willem A.; Richard, Edo


    Background and Purpose-Cortical microinfarcts (CMIs) are a common postmortem finding associated with vascular risk factors, cognitive decline, and dementia. Recently, CMIs identified in vivo on 7 Tesla MRI also proved retraceable on 3 Tesla MRI. Methods-We evaluated CMIs on 3 Tesla MRI in a populati

  11. Cortical microinfarcts detected in vivo on 3 Tesla MRI: clinical and radiological correlates

    NARCIS (Netherlands)

    Dalen, J.W. van; Scuric, E.E.; Veluw, S.J. van; Caan, M.W.; Nederveen, A.J.; Biessels, G.J.; Gool, W.A. van; Richard, E.


    BACKGROUND AND PURPOSE: Cortical microinfarcts (CMIs) are a common postmortem finding associated with vascular risk factors, cognitive decline, and dementia. Recently, CMIs identified in vivo on 7 Tesla MRI also proved retraceable on 3 Tesla MRI. METHODS: We evaluated CMIs on 3 Tesla MRI in a popula

  12. A review of the safety implications of magnetic resonance imaging at field strengths of 3 Tesla and above

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    Crook, Neil [Alliance Medical, Iceni Centre, Warwick Technology Park, Warwick CV34 6DA (United Kingdom)], E-mail:; Robinson, Leslie [Dept. of Diagnostic Radiography, School of Healthcare Professions, Faculty of Health and Social Care, University of Salford, Salford, Greater Manchester M6 6PU (United Kingdom)


    Rationale: Diagnostic imaging is being driven by technological developments particularly so in the field of Magnetic Resonance Imaging (MRI). Electromagnetic fields used to produce images are becoming much stronger and switched more rapidly and it is essential that safety advice remains appropriate and current. Using a systematic methodology, this review aims to identify the clinical safety implications in performing MRI at field strengths of 3 Tesla (T) and above and determine whether the current clinical safety guidelines are appropriate. Method: References were sourced from The Cochrane Library, Centre for Reviews and Dissemination Science Direct, PubMed and Google Scholar. Related websites searched included The British Institute of Radiology, Society of Radiographers, Royal College of Radiologists, The Institution of Engineering and Technology, IMRSER (Institute for Magnetic Resonance Safety, Education, and Research), MagNet (NHS PASA). References supplied in retrieved papers were also checked for potential relevance. The use of consistent search terminology and inclusion and exclusion criteria ensured quality and provided rigour to conclusions drawn. Conclusion: According to the literature retrieved, the current body of knowledge has allowed safety guidelines to be established for patient safety and these are both appropriate and valid at field strengths of 3 T.

  13. White Matter Brain Lesions in Midlife Familial Hypercholesterolemic Patients at 3-Tesla Magnetic Resonance Imaging

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    Schmitz, S.A.; O' Regan, D.P.; Fitzpatrick, J.; Neuwirth, C.; Potter, E.; Tosi, I.; Hajnal, J.V.; Naoumova, R.P. (Imaging Sciences Dept. and Clinical Research Facility, MRC Clinical Sciences Centre, London (GB))


    Background: Patients with hypercholesterolemia of 60 years and older have an increased risk for white matter brain lesions and dementia. Purpose: To investigate whether patients with familial hypercholesterolemia (FH) develop white matter lesions at 3-Tesla (T) MRI as early as in midlife. Material and Methods: Non-diabetic, non-smoking, and non-hypertensive heterozygous FH patients on treatment with maximally tolerated dose of a statin for more than 5 years (n = 14) and matched controls (n = 22) aged 25 to 60 years of age were studied. Imaging was performed at 3T with a fluid-attenuated T2-weighted MR pulse sequence and a T1-weighted spin-echo pulse sequence following 10 ml of i.v. gadopentetate dimeglumine. Images were evaluated by two independent readers. Fasting blood samples were taken. Student's t test was employed at P<0.05. Results: Three volunteers and one FH patient had white matter lesions (P<0.53). No other evidence of past ischemic stroke was observed. Mean total serum cholesterol and low-density lipoprotein (LDL) cholesterol were significantly higher in the FH group (6.0+-1.1 vs. 5.1+-0.9 mmol/l, P<0.02 and 4.1+-0.9 vs. 3.1+-0.8 mmol/l, P<0.004, respectively). Conclusion: Heterozygous FH patients on statin treatment in the age range of 25 to 60 years are not at increased risk of white matter lesions at 3T MRI

  14. Functionality of veterinary identification microchips following low- (0.5 tesla) and high-field (3 tesla) magnetic resonance imaging. (United States)

    Piesnack, Susann; Frame, Mairi E; Oechtering, Gerhard; Ludewig, Eberhard


    The ability to read patient identification microchips relies on the use of radiofrequency pulses. Since radiofrequency pulses also form an integral part of the magnetic resonance imaging (MRI) process, the possibility of loss of microchip function during MRI scanning is of concern. Previous clinical trials have shown microchip function to be unaffected by MR imaging using a field strength of 1 Tesla and 1.5. As veterinary MRI scanners range widely in field strength, this study was devised to determine whether exposure to lower or higher field strengths than 1 Tesla would affect the function of different types of microchip. In a phantom study, a total of 300 International Standards Organisation (ISO)-approved microchips (100 each of three different types: ISO FDX-B 1.4 × 9 mm, ISO FDX-B 2.12 × 12 mm, ISO HDX 3.8 × 23 mm) were tested in a low field (0.5) and a high field scanner (3.0 Tesla). A total of 50 microchips of each type were tested in each scanner. The phantom was composed of a fluid-filled freezer pack onto which a plastic pillow and a cardboard strip with affixed microchips were positioned. Following an MRI scan protocol simulating a head study, all of the microchips were accurately readable. Neither 0.5 nor 3 Tesla imaging affected microchip function in this study.

  15. Magnetization transfer contrast imaging in bovine and human cortical bone applying an ultrashort echo time sequence at 3 Tesla. (United States)

    Springer, Fabian; Martirosian, Petros; Machann, Jürgen; Schwenzer, Nina F; Claussen, Claus D; Schick, Fritz


    Magnetization transfer (MT) contrast imaging reveals interactions between free water molecules and macromolecules in a variety of tissues. The introduction of ultrashort echo time (UTE) sequences to clinical whole-body MR scanners expands the possibility of MT imaging to tissues with extremely fast signal decay such as cortical bone. The aim of this study was to investigate the MT effect of bovine cortical bone in vitro on a 3 Tesla whole-body MR unit. A 3D-UTE sequence with a rectangular-shaped on-resonant excitation pulse and a Gaussian-shaped off-resonant saturation pulse for MT preparation was applied. The flip angle and off-resonance frequency of the MT pulse was systematically varied. Measurements on various samples of bovine cortical bone, agar gel, aqueous manganese chloride solutions, and solid polymeric materials (polyurethane) were performed, followed by preliminary applications on human tibial bone in vivo. Direct on-resonant saturation effects of the MT prepulses were calculated numerically by means of Bloch's equations. Corrected for direct saturation effects dry and fresh bovine cortical bone showed "true" MTR values of 0.26 and 0.21, respectively. In vivo data were obtained from three healthy subjects and showed MTR values of 0.30 +/- 0.08. In vivo studies into MT of cortical bone might have the potential to give new insights in musculoskeletal pathologies.

  16. Evaluation of 100 brain examinations using a 3 Tesla MR-compatible incubator - safety, handling, and image quality

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    Sirin, Selma; Goericke, Sophia L.; Kinner, Sonja; Schweiger, Bernd [University Hospital Essen, Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Huening, Britta M.; Stein, Anja; Felderhoff-Mueser, Ursula [University Hospital Essen, Department of Neonatology, Division of Pediatrics I, Essen (Germany)


    Several studies have revealed the importance of brain imaging in term and preterm infants. The aim of this retrospective study was to review safety, handling, and image quality of MR brain imaging using a new 3 Tesla MR-compatible incubator. Between 02/2011 and 05/2012 100 brain MRIs (84 infants, mean gestational age 32.2 {+-} 4.7 weeks, mean postmenstrual age at imaging 40.6 {+-} 3.4 weeks) were performed using a 3 Tesla MR-compatible incubator with dedicated, compatible head coil. Seventeen examinations (13 infants, mean gestational age 35.1 {+-} 5.4 weeks, mean postmenstrual age at imaging 47.8 {+-} 7.4 weeks) with a standard head coil served as a control. Image analysis was performed by a neuroradiologist and a pediatric radiologist in consensus. All but two patients with known apnea were transferred to the MR unit and scanned without problems. Handling was easier and faster with the incubator; relevant motion artifacts (5.9 vs. 10.8 %) and the need for repetitive sedation (43.0 vs. 86.7 %) were reduced. Considering only images not impaired by motion artifacts, image quality (4.8 {+-} 0.4 vs. 4.3 {+-} 0.8, p = 0.047) and spatial resolution (4.7 {+-} 0.4 vs. 4.2 {+-} 0.6, p = 0.011) of T2-weighted images were scored significantly higher in patients imaged with the incubator. SNR increased significantly (171.6 {+-} 54.5 vs. 80.5 {+-} 19.8, p < 0.001) with the use of the incubator. Infants can benefit from the use of a 3 Tesla MR-compatible incubator because of its safety, easier, and faster handling (compared to standard imaging) and possibility to obtain high-quality MR images even in unstable patients. (orig.)

  17. Endometrium evaluation with high-field (3-Tesla) magnetic resonance imaging in patients submitted to uterine leiomyoma embolization

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    Jacobs, Monica Amadio Piazza [Post-graduation Program in Abdominal Imaging, Hospital Israelita Albert Einstein, São Paulo, SP (Brazil); Nasser, Felipe [Intervention Radiology Department, Hospital Israelita Albert Einstein, São Paulo, SP (Brazil); Zlotnik, Eduardo; Messina, Marcos de Lorenzo [Gynecology and Obstetrics Department, Hospital Israelita Albert Einstein, São Paulo, SP (Brazil); Baroni, Ronaldo Hueb [Magnetic Resonance Unit, Imaging Department, Hospital Israelita Albert Einstein, São Paulo, SP (Brazil)


    To evaluate the endometrial alterations related to embolization of uterine arteries for the treatment of symptomatic uterine leiomyomatosis (pelvic pain and/or uterine bleeding) by means of high-field (3-Tesla) magnetic resonance. This is a longitudinal and prospective study that included 94 patients with a clinical and imaging diagnosis of symptomatic uterine leiomyomatosis, all of them treated by embolization of the uterine arteries. The patients were submitted to evaluations by high-field magnetic resonance of the pelvis before and 6 months after the procedure. Specific evaluations were made of the endometrium on the T2-weighted sequences, and on the T1-weighted sequences before and after the intravenous dynamic infusion of the paramagnetic contrast. In face of these measures, statistical analyses were performed using Student's t test for comparison of the results obtained before and after the procedure. An average increase of 20.9% was noted in the endometrial signal on T2-weighted images obtained after the uterine artery embolization procedure when compared to the pre-procedure evaluation (p=0.0004). In the images obtained with the intravenous infusion of paramagnetic contrast, an average increase of 18.7% was noted in the post-embolization intensity of the endometrial signal, compared to the pre-embolization measure (p<0.035). After embolization of the uterine arteries, there was a significant increase of the endometrial signal on the T2-weighted images and on the post-contrast images, inferring possible edema and increased endometrial flow. Future studies are needed to assess the clinical impact of these findings.

  18. Accuracy of accelerated cine MR imaging at 3 Tesla in longitudinal follow-up of cardiac function

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    Sandner, Torleif A.; Huber, Armin M.; Theisen, Daniel; Reiser, Maximilian F.; Wintersperger, Bernd J. [Ludwig-Maximilians-University, Department of Clinical Radiology, University Hospitals - Campus Grosshadern, Munich (Germany); Houck, Philip [Texas A and M University Health Science Center, Department of Cardiology, Scott and White Clinic and Hospital, Temple, TX (United States); Runge, Val M.; Sincleair, Spencer [Texas A and M University Health Science Center, Department of Radiology, Scott and White Clinic and Hospital, Temple, TX (United States)


    The ability of fast, parallel-imaging-based cine magnetic resonance (MR) to monitor global cardiac function in longitudinal exams at 3 Tesla was evaluated. Seventeen patients with chronic cardiac disease underwent serial cine MR imaging exams (n=3) at 3 Tesla. Data were acquired in short-axis orientation using cine steady-state free precession (SSFP) with a spatial resolution of 2.5 x 1.9 mm{sup 2} at 45 ms temporal resolution. Multislice imaging (three slices/breath-hold) was performed using TSENSE acceleration (R=3) and standard single-slice cine (non-TSENSE) was performed at identical locations in consecutive breath-holds. End-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF) and myocardial mass (MM) of both cine approaches were compared for individual time-points as well as for longitudinal comparison. TSENSE-cine did not show significant differences for EDV (2.6 ml; P=.79), ESV (2.2 ml; P=0.81), EF (-0.3%; P=0.95) and MM (2.4 g; P=0.72) in comparison with non-TSENSE. Longitudinal ANOVA analysis did not reveal significant differences for any parameter, neither for non-TSENSE data (all P>0.7) nor for TSENSE data (all P>0.9). Multifactorial ANOVA showed non-significant differences (all P>0.7) at comparable data variances. Data acquisition was significantly shortened using TSENSE. Threefold accelerated multislice cine at 3 Tesla allows accurate assessment of volumetric LV data and accurate longitudinal monitoring of global LV function at a substantially shorter overall examination time. (orig.)

  19. Utility and limitations of 3-Tesla diffusion-weighted magnetic resonance imaging for differentiation of renal tumors

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    Sevcenco, S., E-mail: [Medical University of Vienna, Dept. of Urology, Waehringer Gürtel 18-20, 1090 Vienna (Austria); Heinz-Peer, G., E-mail: [Medical University of Vienna, Dept. of Biomedical Imaging and Image-guided Therapy, Waehringer Gürtel 18-20, 1090 Vienna (Austria); Ponhold, L., E-mail: [Medical University of Vienna, Dept. of Biomedical Imaging and Image-guided Therapy, Waehringer Gürtel 18-20, 1090 Vienna (Austria); Javor, D., E-mail: [Medical University of Vienna, Dept. of Biomedical Imaging and Image-guided Therapy, Waehringer Gürtel 18-20, 1090 Vienna (Austria); Kuehhas, F.E., E-mail: [Medical University of Vienna, Dept. of Urology, Waehringer Gürtel 18-20, 1090 Vienna (Austria); Klingler, H.C., E-mail: [Medical University of Vienna, Dept. of Urology, Waehringer Gürtel 18-20, 1090 Vienna (Austria); Remzi, M., E-mail: [Medical University of Vienna, Dept. of Urology, Waehringer Gürtel 18-20, 1090 Vienna (Austria); Weibl, P., E-mail: [Medical University of Vienna, Dept. of Urology, Waehringer Gürtel 18-20, 1090 Vienna (Austria); Shariat, S.F., E-mail: [Medical University of Vienna, Dept. of Urology, Waehringer Gürtel 18-20, 1090 Vienna (Austria); Baltzer, P.A., E-mail: [Medical University of Vienna, Dept. of Biomedical Imaging and Image-guided Therapy, Waehringer Gürtel 18-20, 1090 Vienna (Austria)


    Objective: To investigate utility and limitations of 3-Tesla diffusion-weighted (DW) magnetic resonance imaging (MRI) for differentiation of benign versus malignant renal lesions and renal cell carcinoma (RCC) subtypes. Materials and methods: Sixty patients with 71 renal lesions underwent 3 Tesla DW-MRI of the kidney before diagnostic tissue confirmation. The images were retrospectively evaluated blinded to histology. Single-shot echo-planar imaging was used as the DW imaging technique. Apparent diffusion coefficient (ADC) values were measured and compared with histopathological characteristics. Results: There were 54 malignant and 17 benign lesions, 46 lesions being small renal masses ≤4 cm. Papillary RCC lesions had lower ADC values (p = 0.029) than other RCC subtypes (clear cell or chromophobe). Diagnostic accuracy of DW-MRI for differentiation of papillary from non-papillary RCC was 70.3% resulting in a sensitivity and specificity of 64.3% (95% CI, 35.1–87.2) and 77.1 (95% CI, 59.9–89.6%). Accuracy increased to 83.7% in small renal masses (≤4 cm diameter) and sensitivity and specificity were 75.0% and 88.5%, respectively. The ADC values did not differ significantly between benign and malignant renal lesions (p = 0.45). Conclusions: DW-MRI seems to distinguish between papillary and other subtypes of RCCs especially in small renal masses but could not differentiate between benign and malignant renal lesions. Therefore, the use of DW-MRI for preoperative differentiation of renal lesions is limited.

  20. Magnetic resonance imaging of stents. Quantitative in vitro examination at 3 Tesla; Magnetresonanztomographie von Stents. Quantitative MR-Untersuchungen in vitro bei 3 Tesla

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    Reinhardt, Julia [Neurologische Universitaetsklinik Heidelberg (Germany). Sektion Experimentelle Radiologie; Fachhochschule Jena (Germany). Fachbereich Medizintechnik; Nguyen-Trong, Thien-Hoa; Haehnel, Stefan [Neurologische Universitaetsklinik Heidelberg (Germany). Abt. Neuroradiologie; Bellemann, Matthias E. [Fachhochschule Jena (Germany). Fachbereich Medizintechnik; Heiland, Sabine [Neurologische Universitaetsklinik Heidelberg (Germany). Sektion Experimentelle Radiologie; Neurologische Universitaetsklinik Heidelberg (Germany). Abt. Neuroradiologie


    The aim of this study was to qualitatively and quantitatively study MR artifacts of various stents on the basis of in vitro experiments. We were particularly interested whether sequence type and orientation of the stent with respect to the static magnetic field influences the artifact. We examined 18 stents of different material (nitinol, stainless steel, cobalt alloy), different design of the stent meshes (AccuLink, OmniLink, DynaLink, Xact, Protoge, Wallstent Monorail), different diameter (5-10 mm) and different length (18-58 mm) with a turbo spin echo (TSE), a 2D-fast low angle shot (FLASH) and a 3D-FLASH sequence. The MR images were examined qualitatively with respect to possible artifacts. Furthermore we examined the MR data quantitatively: The contrast-noise-ratio (CNR) was determined both within the stent and outside (within the tube); based on these values we calculated the transparency factor P, furthermore we calculated the apparent vascular lumen within the tube and within the stent. The stents made of stainless steel and cobalt alloy displayed severe susceptibility artifacts. Therefore the vessel lumen within the stent could not be assessed. The nitinol stents showed different artifact patterns: The AccuLink and DynaLink stents showed less artifacts compared to the Xact and Protoge stents. Besides the susceptibility artifacts we found artifacts due to RF shielding by the stent mesh, particularly in TSE sequences. A MR control of patients after stenting is possible and may yield diagnostic information when using the AccuLink or DynaLink stents. However, it is important to make sure that the stent is MR safe for the field strength used for the examination. (orig.)

  1. Assessment of acute intestinal graft versus host disease by abdominal magnetic resonance imaging at 3 Tesla

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    Budjan, Johannes; Michaely, Henrik J.; Attenberger, Ulrike; Haneder, Stefan; Schoenberg, Stefan O. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim (Germany); Heidenreich, Daniela; Kreil, Sebastian; Nolte, Florian; Hofmann, Wolf-Karsten; Klein, Stefan A. [University Medical Center Mannheim, Department of Hematology and Oncology, Mannheim (Germany)


    After allogeneic stem cell transplantation (SCT), a reliable diagnosis of acute graft versus host disease (aGvHD) is essential for an early and successful treatment. It is the aim of this analysis to assess intestinal aGvHD by magnetic resonance imaging (MRI). Prior to allogeneic SCT, 64 consecutive patients underwent abdominal MRI examination on a 3 T MR system, including axial and coronal T2w sequences and a three-dimensional dynamic T1w, contrast enhanced sequence. After SCT, 20 patients with suspected aGvHD received a second MRI as well as an endoscopic examination. Nine patients suffered from histologically proven intestinal aGvHD. In eleven patients intestinal aGvHD was excluded. In all aGvHD patients typical MRI findings with long-segment bowel wall thickening - always involving the terminal ileum - with profound submucosal oedema, were detected. The bowel wall was significantly thickened in patients with intestinal aGvHD. Bowel contrast enhancement spared the submucosa while demonstrating strong mucosal hyperemia. In intestinal aGvHD, a characteristic MR-appearance can be detected. This MRI pattern might facilitate an early and non-invasive diagnosis of intestinal aGvHD. MRI might thus be used as a sensitive tool to rule out or support the clinical diagnosis of aGvHD. (orig.)

  2. Differences in Velopharyngeal Structure during Speech among Asians Revealed by 3-Tesla Magnetic Resonance Imaging Movie Mode

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    Kulthida Nunthayanon


    Full Text Available Objective. Different bony structures can affect the function of the velopharyngeal muscles. Asian populations differ morphologically, including the morphologies of their bony structures. The purpose of this study was to compare the velopharyngeal structures during speech in two Asian populations: Japanese and Thai. Methods. Ten healthy Japanese and Thai females (five each were evaluated with a 3-Tesla (3 T magnetic resonance imaging (MRI scanner while they produced vowel-consonant-vowel syllable (/asa/. A gradient-echo sequence, fast low-angle shot with segmented cine and parallel imaging technique was used to obtain sagittal images of the velopharyngeal structures. Results. MRI was carried out in real time during speech production, allowing investigations of the time-to-time changes in the velopharyngeal structures. Thai subjects had a significantly longer hard palate and produced shorter consonant than Japanese subjects. The velum of the Thai participants showed significant thickening during consonant production and their retroglossal space was significantly wider at rest, whereas the dimensional change during task performance was similar in the two populations. Conclusions. The 3 T MRI movie method can be used to investigate velopharyngeal function and diagnose velopharyngeal insufficiency. The racial differences may include differences in skeletal patterns and soft-tissue morphology that result in functional differences for the affected structures.

  3. Comparison of increased venous contrast in ischemic stroke using phase-sensitive MR imaging with perfusion changes on flow-sensitive alternating inversion recovery at 3 Tesla

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    Yamashita, Eijiro; Kanasaki, Yoshiko; Fujii, Shinya; Ogawa, Toshihide (Div. of Radiology, Dept. of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori Univ. Hospital, Yonago, Tottori (Japan)), email:; Tanaka, Takuro; Hirata, Yoshiharu (Div. of Clinical Radiology, Tottori Univ. Hospital, Yonago, Tottori (Japan))


    Background Increased venous contrast in ischemic stroke using susceptibility-weighted imaging has been widely reported, although few reports have compared increased venous contrast areas with perfusion change areas. Purpose To compare venous contrast on phase-sensitive MR images (PSI) with perfusion change on flow-sensitive alternating inversion recovery (FAIR) images, and to discuss the clinical use of PSI in ischemic stroke. Material and Methods Thirty patients with clinically suspected acute infarction of the middle cerebral artery (MCA) territory within 7 days of onset were evaluated. Phase-sensitive imaging (PSI), flow-sensitive alternating inversion recovery (FAIR), diffusion-weighted imaging (DWI) and magnetic resonance angiography (MRA) were obtained using 3 Tesla scanner. Two neuroradiologists independently reviewed the MR images, as well as the PSI, DWI, and FAIR images. They were blinded to the clinical data and to each other's findings. The abnormal area of each image was ultimately identified after both neuroradiologists reached consensus. We analyzed areas of increased venous contrast on PSI, perfusion changes on FAIR images and signal changes on DWI for each case. Results Venous contrast increased on PSI and hypoperfusion was evident on FAIR images from 22 of the 30 patients (73%). The distribution of the increased venous contrast was the same as that of the hypoperfused areas on FAIR images in 16 of these 22. The extent of these lesions was larger than that of lesions visualized by on DWI in 18 of the 22 patients. Hypointense signals reflecting hemorrhage and no increased venous contrast on PSI and hyperperfusion on FAIR images were found in six of the remaining eight patients (20%). Findings on PSI were normal and hypoperfusion areas were absent on FAIR images of two patients (7%). Conclusion Increased venous contrast on PSI might serve as an index of misery perfusion and provide useful information

  4. Hip imaging of avascular necrosis at 7 Tesla compared with 3 Tesla

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    Theysohn, J.M.; Kraff, O.; Theysohn, N.; Orzada, S.; Lauenstein, T.C. [University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany); University Hospital Essen, Institute for Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Landgraeber, S. [University Hospital Essen, Department of Orthopedic Surgery, Essen (Germany); Ladd, M.E. [University Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen (Germany); German Cancer Research Center, Department of Medical Physics in Radiology, Heidelberg (Germany)


    To compare ultra-high field, high-resolution bilateral magnetic resonance imaging (MRI) of the hips at 7 Tesla (T) with 3 T MRI in patients with avascular necrosis (AVN) of the femoral head by subjective image evaluations, contrast measurements, and evaluation of the appearance of imaging abnormalities. Thirteen subjects with avascular necrosis treated using advanced core decompression underwent MRI at both 7 T and 3 T. Sequence parameters as well as resolution were kept identical for both field strengths. All MR images (MEDIC, DESS, PD/T2w TSE, T1w TSE, and STIR) were evaluated by two radiologists with regard to subjective image quality, soft tissue contrasts, B1 homogeneity (four-point scale, higher values indicating better image quality) and depiction of imaging abnormalities of the femoral heads (three-point scale, higher values indicating the superiority of 7 T). Contrast ratios of soft tissues were calculated and compared with subjective data. 7-T imaging of the femoral joints, as well as 3-T imaging, achieved ''good'' to ''very good'' quality in all sequences. 7 T showed significantly higher soft tissue contrasts for T2w and MEDIC compared with 3 T (cartilage/fluid: 2.9 vs 2.2 and 3.6 vs 2.6), better detailed resolution for cartilage defects (PDw, T2w, T1w, MEDIC, DESS > 2.5) and better visibility of joint effusions (MEDIC 2.6; PDw/T2w 2.4; DESS 2.2). Image homogeneity compared with 3 T (3.9-4.0 for all sequences) was degraded, especially in TSE sequences at 7 T through signal variations (7 T: 2.1-2.9); to a lesser extent also GRE sequences (7 T: 2.9-3.5). Imaging findings related to untreated or treated AVN were better delineated at 3 T (≤1.8), while joint effusions (2.2-2.6) and cartilage defects (2.5-3.0) were better visualized at 7 T. STIR performed much more poorly at 7 T, generating large contrast variations (1.5). 7-T hip MRI showed comparable results in hip joint imaging compared with 3 T with slight

  5. Diffusion-weighted imaging of breast tumours at 3 Tesla and 7 Tesla: a comparison

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    Gruber, S.; Minarikova, L.; Zaric, O.; Chmelik, M.; Strasser, B.; Trattnig, S.; Bogner, W. [Medical University Vienna, MRCE, Department of Biomedical imaging and Image-Guided Therapy, Vienna (Austria); Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna (Austria); Pinker, K.; Baltzer, P.; Helbich, T. [Medical University Vienna, Division of Molecular and Gender Imaging, Department of Biomedical imaging and Image-Guided Therapy, Vienna (Austria)


    To compare bilateral diffusion-weighted MR imaging (DWI) at 3 T and 7 T in the same breast tumour patients. Twenty-eight patients were included in this IRB-approved study (mean age 56 ± 16 years). Before contrast-enhanced imaging, bilateral DWI with b = 0 and 850 s/mm{sup 2} was performed in 2:56 min (3 T) and 3:48 min (7 T), using readout-segmented echo planar imaging (rs-EPI) with a 1.4 x 1.4 mm{sup 2} (3 T)/0.9 x 0.9 mm{sup 2} (7 T) in-plane resolution. Apparent diffusion coefficients (ADC), signal-to-noise (SNR) and contrast-to-noise ratios (CNR) were assessed. Twenty-eight lesions were detected (18 malignant, 10 benign). CNR and SNR were comparable at both field strengths (p > 0.3). Mean ADC values at 7 T were 4-22 % lower than at 3 T (p ≤ 0.03). An ADC threshold of 1.275 x 10{sup -3} mm{sup 2}/s resulted in a diagnostic specificity of 90 % at both field strengths. The sensitivity was 94 % and 100 % at 3 T and 7 T, respectively. 7-T DWI of the breast can be performed with 2.4-fold higher spatial resolution than 3 T, without significant differences in SNR if compared to 3 T. (orig.)

  6. Chemical shift imaging at 3 Tesla: effect of echo time on assessing bone marrow abnormalities

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    Del Grande, F. [The Johns Hopkins Medical Institutions, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Ospedale Regionale di Lugano, Servizio di Radiologia, Lugano, TI (Switzerland); Subhawong, Ty [University of Miami Miller School of Medicine, Department of Radiology, Miami, FL (United States); Flammang, A. [Siemens Medical Solutions USA, Inc., Malvern, PA (United States); Fayad, L.M. [The Johns Hopkins Medical Institutions, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States)


    Our purpose is to test the effect of varied in-phase (IP) and opposed-phase (OP) sequence order on characterizing marrow signal changes at 3T. The study was HIPAA compliant and IRB approved. Informed consent was waived. At 3T, IP and OP sequences were acquired in three patients with biopsy-proven osteosarcomas, using two methods: approach 1 (OP acquisition before IP acquisition) and approach 2 (OP after IP). Signal intensity (SI) measurements in 12 locations of biopsy-proven osteosarcoma and in six locations with normal bone marrow were performed independently by two experienced musculoskeletal radiologists. The signal intensity ratio (SIR) was measured within the marrow where there was T1 signal lower than skeletal muscle. A SIR < 20 % on the OP compared with IP imaging was considered positive for marrow replacement, while SIR > = 20 % was considered negative. Interobserver agreement was measured by the Lin concordance correlation coefficient (CCC). In 75 % (18/24) of locations within the biopsy-proven tumors, the SIR was >20 % (SI drop more than 20 % in OP compared to IP) using approach 2 and in 100 % (24/24) of the locations the SIR was <20 % (SI drop less than 20 % in OP compared to IP) using approach 1, indicating a high percentage of false-negative results by approach 2, and no false-negative results with approach 1. There was good agreement between observer measurement (CCC = 0.96). At 3T, the OP sequence should be acquired prior to the IP sequence, because susceptibility artifacts on a later-acquired OP sequence may lead to an erroneous interpretation of marrow signal abnormalities. (orig.)

  7. Detailed imaging of the normal anatomy and pathologic conditions of the cavernous region at 3 Tesla using a contrast-enhanced MR angiography

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    Linn, Jennifer; Peters, Friederike; Lummel, Nina; Brueckmann, Hartmut; Yousry, Indra [University Hospital Munich, Department of Neuroradiology, Munich (Germany); Schankin, Christoph [University Hospital Munich, Department of Neurology, Munich (Germany); Rachinger, Walter [University Hospital Munich, Department of Neurosurgery, Munich (Germany)


    The purpose of this study was to evaluate the potential of a high-resolution contrast-enhanced magnetic resonance angiography (CE-MRA) at 3 Tesla for the delineation of the cavernous sinus (CS) anatomy both under normal and under pathological conditions. Fifteen patients without pathologies in the CS and ten patients with pituitary adenomas were included. The CE-MRA was performed on a 3-Tesla scanner and analyzed collaboratively by two readers. The cranial nerves (CNs) within the CS, namely CNIII, CNIV, CNV1, CNV2, and CNVI, were identified in both patient groups. In the adenoma patients it was also assessed whether and to which extend the adenoma invaded the CS and the spatial relationship between tumor and CNs was determined. In the patients with normal CS anatomy, CNIII could be identified in 100%, CNIV in 86.7%, and CNV1, CNV2, as well as CNVI in 100% of analyzed sides. Pituitary adenomas invaded the CS unilaterally (right side) in four patients, and bilaterally in six patients. In patients with adenomas, the CN could be identified and differentiated from the tumor in the following percentages: CNIII in 100%, CNIV in 70%, both CNV1 and CNV2 in 90%, and CNVI in 100%. In all these cases, the tumor-nerve spatial relationship could be visualized. 3-Tesla CE-MRA allows detailed imaging of the complex anatomy of the CS and its structures. In adenoma patients, it clearly visualizes the spatial relationship between tumor and CNs, and thus might be helpful to optimize presurgical planning. (orig.)

  8. Multisequence-imaging protocols to detect cortical lesions of patients with multiple sclerosis: observations from a post-mortem 3 Tesla imaging study. (United States)

    Bagnato, Francesca; Yao, Bing; Cantor, Fredric; Merkle, Hellmut; Condon, Ellen; Montequin, Marcela; Moore, Sandra; Quezado, Martha; Tkaczyk, Deborah; McFarland, Henry


    Neocortical lesions (NLs) are an important component of multiple sclerosis (MS) pathology and may account for part of the physical and cognitive disability. Visualizing NLs of patients with MS using magnetic resonance imaging (MRI) poses several significant challenges. We optimized the inversion time (TI) of T(1)-based magnetization-prepared rapid acquisition gradient-echo (MPRAGE) images by suppressing the signal of the lesions and enhancing their appearance as hypointensities, on the basis of the derived quantitative T(1) measurements. The latter were achieved by the means of 2D inversion recovery fast spin echo (IR-FSE), repeated using different inversion times (TI). Comparisons of detection of NLs by MPRAGE and dual echo T(2) weighted (T(2)W) and proton density (PD) W. Four coronal brain slices from a deceased MS patient and two coronal brain slices from two formerly healthy donors were imaged using a 3 Tesla magnet (3 T) equipped with a multi-channel coil. Based upon the averaged T1 values computed from the MS specimen as well as visual inspection, an optimal TI of 380 ms was selected for the MPRAGE image. No NLs were seen in the specimens of the two healthy donors. Of the 40 total NLs observed, 8 (20%) were visible in all three sequences employed. Three (7.5%) NLs were visible only in the PDW image and 5 (12.5%) were seen only in the T(2)W image. Four NLs (10%) had clearly unique conspicuity in the MPRAGE image. Of those, 3 were retrospectively scored in the PDW image (1 NL) or in the T2W image (2 NLs). We conclude that for the detection of MS-related NLs, high-resolution T(1)-based MPRAGE and T(2)-W images offer complementary information and the combination of the two image sequences is crucial for increasing the sensitivity of detecting MS-induced NLs.

  9. Comparison of 3D cube FLAIR with 2D FLAIR for multiple sclerosis imaging at 3 tesla

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    Patzig, M.; Brueckmann, H.; Fesl, G. [Muenchen Univ. (Germany). Dept. of Neuroradiology; Burke, M. [GE Healthcare, Solingen (Germany)


    Purpose: Three-dimensional (3 D) MRI sequences allow improved spatial resolution with good signal and contrast properties as well as multiplanar reconstruction. We sought to compare Cube, a 3 D FLAIR sequence, to a standard 2 D FLAIR sequence in multiple sclerosis (MS) imaging. Materials and Methods: Examinations were performed in the clinical routine on a 3.0 Tesla scanner. 12 patients with definite MS were included. Lesions with MS-typical properties on the images of Cube FLAIR and 2 D FLAIR sequences were counted and allocated to different brain regions. Signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNR) were calculated. Results: With 384 the overall number of lesions found with Cube FLAIR was significantly higher than with 2 D FLAIR (N = 221). The difference was mostly accounted for by supratentorial lesions (N = 372 vs. N = 216) while the infratentorial lesion counts were low in both sequences. SNRs and CNRs were significantly higher in CUBE FLAIR with the exception of the CNR of lesion to gray matter, which was not significantly different. Conclusion: Cube FLAIR showed a higher sensitivity for MS lesions compared to a 2 D FLAIR sequence. 3 D FLAIR might replace 2 D FLAIR sequences in MS imaging in the future. (orig.)

  10. Assessment of safety and interference issues of radio frequency identification devices in 0.3 Tesla magnetic resonance imaging and computed tomography. (United States)

    Periyasamy, M; Dhanasekaran, R


    The objective of this study was to evaluate two issues regarding magnetic resonance imaging (MRI) including device functionality and image artifacts for the presence of radio frequency identification devices (RFID) in association with 0.3 Tesla at 12.7 MHz MRI and computed tomography (CT) scanning. Fifteen samples of RFID tags with two different sizes (wristband and ID card types) were tested. The tags were exposed to several MR-imaging conditions during MRI examination and X-rays of CT scan. Throughout the test, the tags were oriented in three different directions (axial, coronal, and sagittal) relative to MRI system in order to cover all possible situations with respect to the patient undergoing MRI and CT scanning, wearing a RFID tag on wrist. We observed that the tags did not sustain physical damage with their functionality remaining unaffected even after MRI and CT scanning, and there was no alternation in previously stored data as well. In addition, no evidence of either signal loss or artifact was seen in the acquired MR and CT images. Therefore, we can conclude that the use of this passive RFID tag is safe for a patient undergoing MRI at 0.3 T/12.7 MHz and CT Scanning.

  11. Investigation of Parallel Radiofrequency Transmission for the Reduction of Heating in Long Conductive Leads in 3 Tesla Magnetic Resonance Imaging.

    Directory of Open Access Journals (Sweden)

    Clare E McElcheran

    Full Text Available Deep Brain Stimulation (DBS is increasingly used to treat a variety of brain diseases by sending electrical impulses to deep brain nuclei through long, electrically conductive leads. Magnetic resonance imaging (MRI of patients pre- and post-implantation is desirable to target and position the implant, to evaluate possible side-effects and to examine DBS patients who have other health conditions. Although MRI is the preferred modality for pre-operative planning, MRI post-implantation is limited due to the risk of high local power deposition, and therefore tissue heating, at the tip of the lead. The localized power deposition arises from currents induced in the leads caused by coupling with the radiofrequency (RF transmission field during imaging. In the present work, parallel RF transmission (pTx is used to tailor the RF electric field to suppress coupling effects. Electromagnetic simulations were performed for three pTx coil configurations with 2, 4, and 8-elements, respectively. Optimal input voltages to minimize coupling, while maintaining RF magnetic field homogeneity, were determined for all configurations using a Nelder-Mead optimization algorithm. Resulting electric and magnetic fields were compared to that of a 16-rung birdcage coil. Experimental validation was performed with a custom-built 4-element pTx coil. In simulation, 95-99% reduction of the electric field at the tip of the lead was observed between the various pTx coil configurations and the birdcage coil. Maximal reduction in E-field was obtained with the 8-element pTx coil. Magnetic field homogeneity was comparable to the birdcage coil for the 4- and 8-element pTx configurations. In experiment, a temperature increase of 2±0.15°C was observed at the tip of the wire using the birdcage coil, whereas negligible increase (0.2±0.15°C was observed with the optimized pTx system. Although further research is required, these initial results suggest that the concept of optimizing p

  12. Volume and asymmetry abnormalities of insula in antipsychotic-naive schizophrenia: A 3-Tesla magnetic resonance imaging study

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    Harve Shanmugam Virupaksha


    Full Text Available Context: Insula, which is a vital brain region for self-awareness, empathy, and sensory stimuli processing, is critically implicated in schizophrenia pathogenesis. Existing studies on insula volume abnormalities report inconsistent findings potentially due to the evaluation of ′antipsychotic-treated′ schizophrenia patients as well as suboptimal methodology. Aim: To understand the role of insula in schizophrenia. Materials and Methods: In this first-time 3-T magnetic resonance imaging study, we examined antipsychotic-naive schizophrenic patients (N=30 and age-, sex-, handedness- and education-matched healthy controls (N=28. Positive and negative symptoms were scored with good interrater reliability (intraclass correlation coefficient (ICC>0.9 by using the scales for negative and positive symptoms. Gray matter volume of insula and its anterior/posterior subregions were measured by using a three-dimensional, interactive, semiautomated software based on the valid method with good interrater reliability (ICC>0.85. Intracranial volume was automatically measured by using the FreeSurfer software. Results: Patients had significantly deficient gray matter volumes of left (F=33.4; Pleft in male patients in comparison with male controls (left>right (t=2.7; P=0.01. Conclusions: Robust insular volume deficits in antipsychotic-naive schizophrenia support intrinsic role for insula in pathogenesis of this disorder. The first-time demonstration of a relationship between right posterior insular deficit and negative symptoms is in tune with the background neurobiological literature. Another novel observation of sex-specific anterior insular asymmetry reversal in patients supports evolutionary postulates of schizophrenia pathogenesis.

  13. Impact of preoperative and postoperative membranous urethral length measured by 3 Tesla magnetic resonance imaging on urinary continence recovery after robotic-assisted radical prostatectomy (United States)

    Song, Wan; Kim, Chan Kyo; Park, Byung Kwan; Jeon, Hwang Gyun; Jeong, Byong Chang; Seo, Seong Il; Jeon, Seong Soo; Choi, Han Yong; Lee, Hyun Moo


    Introduction We sought to investigate the impact of preoperative and postoperative membranous urethral length (MUL) on urinary continence using 3 Tesla (3T) magnetic resonance imaging (MRI) after robotic-assisted radical prostatectomy (RARP). Methods Between 2008 and 2013, 190 men with RARP underwent preoperative and postoperative MRI. Patients who received adjuvant radiotherapy or who were lost to followup were excluded, leaving 186 patients eligible for analysis. Preoperative MUL was estimated from the prostate apex to the penile bulb, while postoperative MUL was estimated from the bladder neck to penile bulb. Patients with no pads or protection were considered to have complete continence. Logistic regression analysis was used to identify predictors associated with urinary incontinence at six and 12 months. Results Age was commonly associated with urinary incontinence at six and 12 months. In addition, diabetes mellitus (DM) was another factor associated with urinary incontinence at 12 months. When adjusting these variables, preoperative MUL ≤16 mm (95% confidence interval [CI] 1.01–1.14; p=0.022), postoperative MUL ≤14 mm (95% CI 1.16–9.80; p=0.025) and percent change of MUL >18% (95% CI 1.17–7.23; p=0.021) were significantly associated with urinary incontinence at six months. However, at 12 months, preoperative MUL ≤13.5 mm (95% CI 1.85–19.21; p=0.003) and postoperative MUL ≤13 mm (95% CI 1.24–13.84; p=0.021) had impacts on urinary incontinence, but not percent change of MUL. Conclusions Preoperative and postoperative MUL were significantly associated with urinary continence recovery after RARP. Therefore, efforts to preserve MUL are highly recommended during surgery for optimal continence outcomes after RARP. PMID:28360954

  14. The Role of 3 Tesla Diffusion-Weighted Imaging in the Differential Diagnosis of Benign versus Malignant Cervical Lymph Nodes in Patients with Head and Neck Squamous Cell Carcinoma


    Flavio Barchetti; Nicola Pranno; Guglielmo Giraldi; Alessandro Sartori; Silvia Gigli; Giovanni Barchetti; Luigi Lo Mele; Luigi Tonino Marsella


    Objective. The aim of this study was to validate the role of diffusion-weighted imaging (DWI) at 3 Tesla in the differential diagnosis between benign and malignant laterocervical lymph nodes in patients with head and neck squamous cell carcinoma (HNSCC). Materials and Methods. Before undergoing surgery, 80 patients, with biopsy proven HNSCC, underwent a magnetic resonance exam. Sensitivity (Se) and specificity (Spe) of conventional criteria and DWI in detecting laterocervical lymph node metas...

  15. Comparison of Brain Activation Images Associated with Sexual Arousal Induced by Visual Stimulation and SP6 Acupuncture: fMRI at 3 Tesla

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    Choi, Nam Gil [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of); Han, Jae Bok; Jang, Seong Joo [Dept. of Radiology, Dongshin University, Naju (Korea, Republic of)


    This study was performed not only to compare the brain activation regions associated with sexual arousal induced by visual stimulation and SP6 acupuncture, but also to evaluate its differential neuro-anatomical mechanism in healthy women using functional magnetic resonance imaging (fMRI) at 3 Tesla (T). A total of 21 healthy right-handed female volunteers (mean age 22 years, range 19 to 32) underwent fMRI on a 3T MR scanner. The stimulation paradigm for sexual arousal consisted of two alternating periods of rest and activation. It began with a 1-minute rest period, 3 minutes of stimulation with either of an erotic video film or SP6 acupuncture, followed by 1-minute rest. In addition, a comparative study on the brain activation patterns between an acupoint and a shampoint nearby GB37 was performed. The fMRI data were obtained from 20 slices parallel to the AC-PC line on an axial plane, giving a total of 2,000 images. The mean activation maps were constructed and analyzed by using the statistical parametric mapping (SPM99) software. As comparison with the shampoint, the acupoint showed 5 times and 2 times higher activities in the neocortex and limbic system, respectively. Note that brain activation in response to stimulation with the shampoint was not observed in the regions including the HTHL in the diencephalon, GLO and AMYG in the basal ganglia, and SMG in the parietal lobe. In the comparative study of visual stimulation vs. SP6 acupuncture, the mean activation ratio of stimulus was not significantly different to each other in both the neocortex and the limbic system (p < 0.05). The mean activities induced by both stimuli were not significantly different in the neocortex, whereas the acupunctural stimulation showed higher activity in the limbic system (p < 0.05). This study compared the differential brain activation patterns and the neural mechanisms for sexual arousal, which were induced by visual stimulation and SP6 acupuncture by using 3T fMRI. These findings

  16. Breast MRI at 7 Tesla with a bilateral coil and T1-weighted acquisition with robust fat suppression: image evaluation and comparison with 3 Tesla

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    Brown, Ryan; Storey, Pippa; McGorty, KellyAnne; Klautau Leite, Ana Paula; Babb, James; Sodickson, Daniel K.; Wiggins, Graham C.; Moy, Linda [New York University Langone Medical Center, Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York, NY (United States); Geppert, Christian [Siemens Medical Solutions USA Inc., New York, NY (United States)


    To evaluate the image quality of T1-weighted fat-suppressed breast MRI at 7 T and to compare 7-T and 3-T images. Seventeen subjects were imaged using a 7-T bilateral transmit-receive coil and 3D gradient echo sequence with adiabatic inversion-based fat suppression (FS). Images were graded on a five-point scale and quantitatively assessed through signal-to-noise ratio (SNR), fibroglandular/fat contrast and signal uniformity measurements. Image scores at 7 and 3 T were similar on standard-resolution images (1.1 x 1.1 x 1.1-1.6 mm{sup 3}), indicating that high-quality breast imaging with clinical parameters can be performed at 7 T. The 7-T SNR advantage was underscored on 0.6-mm isotropic images, where image quality was significantly greater than at 3 T (4.2 versus 3.1, P {<=} 0.0001). Fibroglandular/fat contrast was more than two times higher at 7 T than at 3 T, owing to effective adiabatic inversion-based FS and the inherent 7-T signal advantage. Signal uniformity was comparable at 7 and 3 T (P < 0.05). Similar 7-T image quality was observed in all subjects, indicating robustness against anatomical variation. The 7-T bilateral transmit-receive coil and adiabatic inversion-based FS technique produce image quality that is as good as or better than at 3 T. (orig.)

  17. Incidental optochiasmatic cavernoma: Case report of an unusual finding on 3 Tesla MRI. (United States)

    Trentadue, Mirko; Pozzi Mucelli, Roberto; Piovan, Enrico; Pizzini, Francesca Benedetta


    Cavernoma is a vascular hamartoma, which represents 10-20% of all central nervous system vascular malformations. The majority (80%) of them are supratentorial, while involvement of the cranial nerves and the optic pathways is extremely rare. The main clinical presentation of optochiasmatic cavernomas consists of chiasmatic apoplexy, which is a neurosurgical emergency. Here, we report a case in which the finding was incidentally detected in a 49-year-old man. We describe the imaging characteristics of the lesion in such a rare location, highlighting the role of magnetic resonance imaging (MRI) (specifically 3 Tesla) in the management of asymptomatic patients.

  18. Quantification of Abdominal Fat in Obese and Healthy Adolescents Using 3 Tesla Magnetic Resonance Imaging and Free Software for Image Analysis (United States)

    Eloi, Juliana Cristina; Epifanio, Matias; de Gonçalves, Marília Maia; Pellicioli, Augusto; Vieira, Patricia Froelich Giora; Dias, Henrique Bregolin; Bruscato, Neide; Soder, Ricardo Bernardi; Santana, João Carlos Batista; Mouzaki, Marialena; Baldisserotto, Matteo


    Background and Aims Computed tomography, which uses ionizing radiation and expensive software packages for analysis of scans, can be used to quantify abdominal fat. The objective of this study is to measure abdominal fat with 3T MRI using free software for image analysis and to correlate these findings with anthropometric and laboratory parameters in adolescents. Methods This prospective observational study included 24 overweight/obese and 33 healthy adolescents (mean age 16.55 years). All participants underwent abdominal MRI exams. Visceral and subcutaneous fat area and percentage were correlated with anthropometric parameters, lipid profile, glucose metabolism, and insulin resistance. Student’s t test and Mann-Whitney’s test was applied. Pearson’s chi-square test was used to compare proportions. To determine associations Pearson’s linear correlation or Spearman’s correlation were used. Results In both groups, waist circumference (WC) was associated with visceral fat area (P = 0.001 and P = 0.01 respectively), and triglycerides were associated with fat percentage (P = 0.046 and P = 0.071 respectively). In obese individuals, total cholesterol/HDL ratio was associated with visceral fat area (P = 0.03) and percentage (P = 0.09), and insulin and HOMA-IR were associated with visceral fat area (P = 0.001) and percentage (P = 0.005). Conclusions 3T MRI can provide reliable and good quality images for quantification of visceral and subcutaneous fat by using a free software package. The results demonstrate that WC is a good predictor of visceral fat in obese adolescents and visceral fat area is associated with total cholesterol/HDL ratio, insulin and HOMA-IR. PMID:28129354

  19. Tumor Detection at 3 Tesla with an Activatable Cell Penetrating Peptide Dendrimer (ACPPD-Gd, a T1 Magnetic Resonance (MR Molecular Imaging Agent.

    Directory of Open Access Journals (Sweden)

    Christopher D Malone

    Full Text Available The ability to detect small malignant lesions with magnetic resonance imaging (MRI is limited by inadequate accumulations of Gd with standard chelate agents. To date, no T1-targeted agents have proven superiority to Gd chelates in their ability to detect small tumors at clinically relevant field strengths. Activatable cell-penetrating peptides and their Gd-loaded dendrimeric form (ACPPD-Gd have been shown to selectively accumulate in tumors. In this study we compared the performance of ACPPD-Gd vs. untargeted Gd chelates to detect small tumors in rodent models using a clinical 3T-MR system.This study was approved by the Institutional-Animal Care-and-Use Committee. 2 of 4 inguinal breast fat pads of 16 albino-C57BL/6 mice were inoculated with tumor Py8119 cells and the other 2 with saline at random. MRI at 3T was performed at 4, 9, and 14 days after inoculation on 8 mice 24-hours after injection of 0.036mmol Gd/kg (ACPPD-Gd, and before and 2-3 minutes after 0.1 mmol/kg gadobutrol on the other 8 mice. T1-weighted (T1w tumor signal normalized to muscle, was compared among the non-contrast, gadobutrol, and ACPPD-Gd groups using ANOVA. Experienced and trainee readers blinded to experimental conditions assessed for the presence of tumor in each of the 4 breast regions. Receiver operator characteristic (ROC curves and area-under-curve (AUC values were constructed and analyzed.Tumors ≥1mm3 were iso-intense to muscle without contrast on T1w sequences. They enhanced diffusely and homogeneously by 57±20% (p5mm3 were removed from the ROC analysis for both the experienced observer (0.96 vs. 0.86 and more so for the trainee (0.86 vs. 0.69, p = 0.04.ACPPD-Gd enhances MMP-expressing tumors of any size at 3T 24 hours after administration, improving their detection by blinded observers when compared to non-contrast and contrast groups given commercial Gd-chelates and imaged during the equilibrium phase.

  20. Is the Ellipsoid Formula the New Standard for 3-Tesla MRI Prostate Volume Calculation without Endorectal Coil? (United States)

    Haas, Matthias; Günzel, Karsten; Miller, Kurt; Hamm, Bernd; Cash, Hannes; Asbach, Patrick


    Prostate volume in multiparametric MRI (mpMRI) is of clinical importance. For 3-Tesla mpMRI without endorectal coil, there is no distinctive standard for volume calculation. We tested the accuracy of the ellipsoid formula with planimetric volume measurements as reference and investigated the correlation of gland volume and cancer detection rate on MRI/ultrasound (MRI/US) fusion-guided biopsy. One hundred forty-three patients with findings on 3-Tesla mpMRI suspicious of cancer and subsequent MRI/US fusion-guided targeted biopsy and additional systematic biopsy were analyzed. T2-weighted images were used for measuring the prostate diameters and for planimetric volume measurement by a segmentation software. Planimetric and calculated prostate volumes were compared with clinical data. The median prostate volume was 48.1 ml (interquartile range (IQR) 36.9-62.1 ml). Volume calculated by the ellipsoid formula showed a strong concordance with planimetric volume, with a tendency to underestimate prostate volume (median volume 43.1 ml (IQR 31.2-58.8 ml); r = 0.903, p < 0.001). There was a moderate, significant inverse correlation of prostate volume to a positive biopsy result (r = -0.24, p = 0.004). The ellipsoid formula gives sufficient approximation of prostate volume on 3-Tesla mpMRI without endorectal coil. It allows a fast, valid volume calculation in prostate MRI datasets.

  1. The Role of 3 Tesla Diffusion-Weighted Imaging in the Differential Diagnosis of Benign versus Malignant Cervical Lymph Nodes in Patients with Head and Neck Squamous Cell Carcinoma (United States)

    Pranno, Nicola; Sartori, Alessandro; Gigli, Silvia; Lo Mele, Luigi; Marsella, Luigi Tonino


    Objective. The aim of this study was to validate the role of diffusion-weighted imaging (DWI) at 3 Tesla in the differential diagnosis between benign and malignant laterocervical lymph nodes in patients with head and neck squamous cell carcinoma (HNSCC). Materials and Methods. Before undergoing surgery, 80 patients, with biopsy proven HNSCC, underwent a magnetic resonance exam. Sensitivity (Se) and specificity (Spe) of conventional criteria and DWI in detecting laterocervical lymph node metastases were calculated. Histological results from neck dissection were used as standard of reference. Results. In the 239 histologically proven metastatic lymphadenopathies, the mean apparent diffusion coefficient (ADC) value was 0.903 × 10−3 mm2/sec. In the 412 pathologically confirmed benign lymph nodes, an average ADC value of 1.650 × 10−3 mm2/sec was found. For differentiating between benign versus metastatic lymph nodes, DWI showed Se of 97% and Spe of 93%, whereas morphological criteria displayed Se of 61% and Spe of 98%. DWI showed an area under the ROC curve (AUC) of 0.964, while morphological criteria displayed an AUC of 0.715. Conclusions. In a DWI negative neck for malignant lymph nodes, the planned dissection could be converted to a wait-and-scan policy, whereas DWI positive neck would support the decision to perform a neck dissection. PMID:25003115

  2. The Role of 3 Tesla Diffusion-Weighted Imaging in the Differential Diagnosis of Benign versus Malignant Cervical Lymph Nodes in Patients with Head and Neck Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Flavio Barchetti


    Full Text Available Objective. The aim of this study was to validate the role of diffusion-weighted imaging (DWI at 3 Tesla in the differential diagnosis between benign and malignant laterocervical lymph nodes in patients with head and neck squamous cell carcinoma (HNSCC. Materials and Methods. Before undergoing surgery, 80 patients, with biopsy proven HNSCC, underwent a magnetic resonance exam. Sensitivity (Se and specificity (Spe of conventional criteria and DWI in detecting laterocervical lymph node metastases were calculated. Histological results from neck dissection were used as standard of reference. Results. In the 239 histologically proven metastatic lymphadenopathies, the mean apparent diffusion coefficient (ADC value was 0.903 × 10−3 mm2/sec. In the 412 pathologically confirmed benign lymph nodes, an average ADC value of 1.650 × 10−3 mm2/sec was found. For differentiating between benign versus metastatic lymph nodes, DWI showed Se of 97% and Spe of 93%, whereas morphological criteria displayed Se of 61% and Spe of 98%. DWI showed an area under the ROC curve (AUC of 0.964, while morphological criteria displayed an AUC of 0.715. Conclusions. In a DWI negative neck for malignant lymph nodes, the planned dissection could be converted to a wait-and-scan policy, whereas DWI positive neck would support the decision to perform a neck dissection.

  3. Assessment of Safety and Interference Issues of Radio Frequency Identification Devices in 0.3 Tesla Magnetic Resonance Imaging and Computed Tomography

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    M. Periyasamy


    Full Text Available The objective of this study was to evaluate two issues regarding magnetic resonance imaging (MRI including device functionality and image artifacts for the presence of radio frequency identification devices (RFID in association with 0.3 Tesla at 12.7 MHz MRI and computed tomography (CT scanning. Fifteen samples of RFID tags with two different sizes (wristband and ID card types were tested. The tags were exposed to several MR-imaging conditions during MRI examination and X-rays of CT scan. Throughout the test, the tags were oriented in three different directions (axial, coronal, and sagittal relative to MRI system in order to cover all possible situations with respect to the patient undergoing MRI and CT scanning, wearing a RFID tag on wrist. We observed that the tags did not sustain physical damage with their functionality remaining unaffected even after MRI and CT scanning, and there was no alternation in previously stored data as well. In addition, no evidence of either signal loss or artifact was seen in the acquired MR and CT images. Therefore, we can conclude that the use of this passive RFID tag is safe for a patient undergoing MRI at 0.3 T/12.7 MHz and CT Scanning.

  4. Is the Susceptibility Vessel Sign on 3-Tesla Magnetic Resonance T2*-Weighted Imaging a Useful Tool to Predict Recanalization in Intravenous Tissue Plasminogen Activator? (United States)

    Yamamoto, N; Satomi, J; Harada, M; Izumi, Y; Nagahiro, S; Kaji, R


    The aim of this study was to investigate the independent factors associated with the absence of recanalization approximately 24 h after intravenous administration of tissue-type plasminogen activator (IV TPA). The previous studies have been conducted using 1.5-Tesla (T) magnetic resonance imaging (MRI). We studied whether the characteristics of 3-T MRI findings were useful to predict outcome and recanalization after IV tPA. Patients with internal carotid artery (ICA) or middle cerebral artery (MCA) (horizontal portion, M1; Sylvian portion, M2) occlusion and treated by IV tPA were enrolled. We studied whether the presence of susceptibility vessel sign (SVS) at M1 and low clot burden score on T2*-weighted imaging (T2*-CBS) on 3-T MRI were associated with the absence of recanalization. A total of 49 patients were enrolled (27 men; mean age, 73.9 years). MR angiography obtained approximately 24 h after IV tPA revealed recanalization in 21 (42.9 %) patients. Independent factors associated with the absence of recanalization included ICA or proximal M1 occlusion (odds ratio, 69.6; 95 % confidence interval, 5.05-958.8, p = 0.002). In this study, an independent factor associated with the absence of recanalization may be proximal occlusion of the cerebral arteries rather than SVS in the MCA or low T2*-CBS on 3-T MRI.

  5. Molecular MRI differentiation between primary central nervous system lymphomas and high-grade gliomas using endogenous protein-based amide proton transfer MR imaging at 3 Tesla

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    Jiang, Shanshan [Southern Medical University, Department of Radiology, Zhujiang Hospital, Guangzhou, Guangdong (China); Johns Hopkins University School of Medicine, Department of Radiology, Baltimore, MD (United States); Yu, Hao; Wang, Xianlong; Lu, Shilong; Feng, Lyujin; Wen, Zhibo [Southern Medical University, Department of Radiology, Zhujiang Hospital, Guangzhou, Guangdong (China); Li, Yufa [Southern Medical University, Department of Pathology, Zhujiang Hospital, Guangzhou, Guangdong (China); Zhang, Yi; Heo, Hye-Young; Lee, Dong-Hoon; Zhou, Jinyuan [Johns Hopkins University School of Medicine, Department of Radiology, Baltimore, MD (United States)


    To show the ability of using the amide proton transfer-weighted (APTW) MRI signals as imaging biomarkers to differentiate primary central nervous system lymphomas (PCNSLs) from high-grade gliomas (HGGs). Eleven patients with lymphomas and 21 patients with HGGs were examined. Magnetization-transfer (MT) spectra over an offset range of ±6 ppm and the conventional MT ratio (MTR) at 15.6 ppm were acquired. The APTW signals, total chemical-exchange-saturation-transfer signal (integral between 0 and 5 ppm, CEST{sub total}), and MTR signal were obtained and compared between PCNSLs and HGGs. The diagnostic performance was assessed with the receiver operating characteristic (ROC) curve analysis. The PCNSLs usually showed more homogeneous APTW hyperintensity (spatially compared to normal brain tissue) than the HGGs. The APTW{sub max}, APTW{sub max-min} and CEST{sub total} signal intensities were significantly lower (P < 0.05, 0.001 and 0.05, respectively), while the APTW{sub min} and MTR were significantly higher (both P < 0.01) in PCNSL lesions than in HGG lesions. The APTW values in peritumoral oedema were significantly lower for PCNSLs than for HGGs (P < 0.01). APTW{sub max-min} had the highest area under the ROC curve (0.963) and accuracy (94.1 %) in differentiating PCNSLs from HGGs. The protein-based APTW signal would be a valuable MRI biomarker by which to identify PCNSLs and HGGs presurgically. (orig.)

  6. Interdependencies of aortic arch secondary flow patterns, geometry, and age analysed by 4-dimensional phase contrast magnetic resonance imaging at 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Frydrychowicz, Alex [University Hospital Schleswig-Holstein, Clinic for Radiology and Nuclear Medicine, Luebeck (Germany); Berger, Alexander; Russe, Maximilian F.; Bock, Jelena [University Hospital Freiburg, Department of Radiology, Medical Physics, Freiburg (Germany); Munoz del Rio, Alejandro [University of Wisconsin - Madison, Departments of Radiology and Medical Physics, Madison, WI (United States); Harloff, Andreas [University Hospital Freiburg, Department of Neurology and Clinical Neurophysiology, Freiburg (Germany); Markl, Michael [University Hospital Freiburg, Department of Radiology, Medical Physics, Freiburg (Germany); Northwestern University, Departments of Radiology and Biomedical Engineering, Chicago, IL (United States)


    It was the aim to analyse the impact of age, aortic arch geometry, and size on secondary flow patterns such as helix and vortex flow derived from flow-sensitive magnetic resonance imaging (4D PC-MRI). 62 subjects (age range = 20-80 years) without circumscribed pathologies of the thoracic aorta (ascending aortic (AAo) diameter: 3.2 {+-} 0.6 cm [range 2.2-5.1]) were examined by 4D PC-MRI after IRB-approval and written informed consent. Blood flow visualisation based on streamlines and time-resolved 3D particle traces was performed. Aortic diameter, shape (gothic, crook-shaped, cubic), angle, and age were correlated with existence and extent of secondary flow patterns (helicity, vortices); statistical modelling was performed. Helical flow was the typical pattern in standard crook-shaped aortic arches. With altered shapes and increasing age, helicity was less common. AAo diameter and age had the highest correlation (r = 0.69 and 0.68, respectively) with number of detected vortices. None of the other arch geometric or demographic variables (for all, P {>=} 0.177) improved statistical modelling. Substantially different secondary flow patterns can be observed in the normal thoracic aorta. Age and the AAo diameter were the parameters correlating best with presence and amount of vortices. Findings underline the importance of age- and geometry-matched control groups for haemodynamic studies. (orig.)

  7. Functional imaging of acute kidney injury at 3 Tesla. Investigating multiple parameters using DCE-MRI and a two-compartment filtration model

    Energy Technology Data Exchange (ETDEWEB)

    Zoellner, Frank G.; Zimmer, Fabian; Schad, Lothar R. [Heidelberg Univ., Mannheim (Germany). Computer Assisted Clinical Medicine; Klotz, Sarah; Hoeger, Simone [Heidelberg Univ., Mannheim (Germany). Dept. of Medicine V


    To investigate how MR-based parameters reflect functional changes in kidneys with acute kidney injury (AKI) using dynamic contrast enhanced MRI and a two-compartment renal filtration model. MRI data of eight male Lewis rats were analyzed retrospectively. Five animals were subjected to AKI, three native rats served as control. All animals underwent perfusion imaging by dynamic contrast-enhanced MRI. Renal blood volume, glomerular filtration rate (GFR) as well as plasma and tubular mean transit times were estimated from regions-of-interest drawn in the renal cortex. Differences between healthy kidneys and kidneys subjected to AKI were analyzed using a paired t-test. Significant differences between ischemic and healthy kidneys could only be detected for the glomerular filtration rate. For all other calculated parameters, differences were present, however not significant. In rats with AKI, average single kidney GFR was 0.66 ± 0.37 ml/min for contralateral and 0.26 ± 0.12 ml/ min for diseased kidneys (P = 0.0254). For the healthy control group, the average GFR was 0.39 ± 0.06 ml/min and 0.41 ± 0.11 ml/min, respectively. Differences between diseased kidneys of AKI rats and ipsilateral kidneys of the healthy control group were significant (P=0.0381). Significant differences of functional parameters reflecting damage of the renal tissue of kidneys with AKI compared to the contralateral, healthy kidneys could only be detected by GFR. GFR might be a useful parameter that allows for a spatially resolved detection of abnormal changes of renal tissue by AKI.

  8. A free-breathing non-contrast-enhanced pulmonary magnetic resonance angiography at 3 Tesla

    Institute of Scientific and Technical Information of China (English)

    YANG Jian; WANG Wei; WANG Ya-rong; NIU Gang; JIN Chen-wang; WU Ed Xuekui


    Background The breathhold contrast-enhanced three-dimensional magnetic resonance angiography (MRA) using T1-weighted gradient-echo imaging sequence is the standard technique for MRA of the thorax. However, this technique is not desirable for certain patients with respiratory insufficiency, serious renal impairment, or allergy to contrast agents. The objective of this study was to optimize and evaluate a non-contrast-enhanced free-breathing pulmonary MRA protocol at 3 Tesla.Methods The time-of-flight protocol was based on a two-dimensional T1-weighted turbo field echo sequence with slice-selective inversion recovery and magnetization transfer preparation together with respiratory navigator gating, cardiac gating, and parallel imaging. Optimal values for time of inversion delay, flip angle and slice thickness were experimentally determined and used for all subjects.Results Excellent pulmonary MRA images, in which the 7th order branches of pulmonary arteries could be reliably identified, were obtained in the 12 free-breathing healthy volunteers. TI of ~300 ms provides the best suppression of background thoracic and cardiac muscles and effective inflow enhancement. With increasing flip angle, the pulmonary vessels gradually brightened and exhibited optimal contrast at 20°-30°. The 2 mm slice thickness and 0.5 mm slice overlap is suitable for visualization of the peripheral pulmonary vessel.Conclusions The MRA protocol at 3 Tesla may have clinical significance for pulmonary vascular imaging in patients who are not available for contrast-enhanced 3D MRA and CT angiography examination or are unable to sustain a long breath-hold.

  9. Dobutamine stress cardiovascular magnetic resonance at 3 Tesla

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    Klein C


    Full Text Available Abstract Purpose The assessment of inducible wall motion abnormalities during high-dose dobutamine-stress cardiovascular magnetic resonance (DCMR is well established for the identification of myocardial ischemia at 1.5 Tesla. Its feasibility at higher field strengths has not been reported. The present study was performed to prospectively determine the feasibility and diagnostic accuracy of DCMR at 3 Tesla for depicting hemodynamically significant coronary artery stenosis (≥ 50% diameter stenosis in patients with suspected or known coronary artery disease (CAD. Materials and methods Thirty consecutive patients (6 women (66 ± 9.3 years were scheduled for DCMR between January and May 2007 for detection of coronary artery disease. Patients were examined with a Philips Achieva 3 Tesla system (Philips Healthcare, Best, The Netherlands, using a spoiled gradient echo cine sequence. Technical parameters were: spatial resolution 2 × 2 × 8 mm3, 30 heart phases, spoiled gradient echo TR/TE: 4.5/2.6 msec, flip angle 15°. Images were acquired at rest and stress in accordance with a standardized high-dose dobutamine-atropine protocol during short breath-holds in three short and three long-axis views. Dobutamine was administered using a standard protocol (10 μg increments every 3 minutes up to 40 μg dobutamine/kg body weight/minute plus atropine if required to reach target heart rate. The study protocol included administration of 0.1 mmol/kg/body weight Gd-DTPA before the cine images at rest were acquired to improve the image quality. The examination was terminated if new or worsening wall-motion abnormalities or chest pain occurred or when > 85% of age-predicted maximum heart rate was reached. Myocardial ischemia was defined as new onset of wall-motion abnormality in at least one segment. In addition, late gadolinium enhancement (LGE was performed. Images were evaluated by two blinded readers. Diagnostic accuracy was determined with coronary

  10. Double-bundle depiction of the anterior cruciate ligament at 3 Tesla

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    Adriaensen, M.E.A.P.M. [Atrium Medical Center Parkstad, Department of Radiology, Heerlen (Netherlands); Hogan, B. [Sports Surgery Clinic, Department of Radiology, Dublin (Ireland); Al-Bulushi, H.I.J. [Armed Forces Hospital, Department of Radiology, Muscat (Oman); Kavanagh, E.C. [Mater Misericordiae Hospital, Department of Radiology, Dublin (Ireland)


    Magnetic resonance imaging on 3 Tesla (3T MRI) with arthroscopic correlation has proven to adequately identify the anteromedial bundle (AMB) and posterolateral bundle (PLB) in cadaver knees. The purpose of this study was to describe the depiction of ACL bundle anatomy on 3T MRI in daily practice. In a retrospective cohort study, we included 50 consecutive patients who underwent standard 3T MRI of the knee and had an intact ACL. Two musculoskeletal radiologists independently reviewed all scans for depiction of ACL bundle anatomy using standardized forms. Descriptive statistics were used. Twenty-three right knees (46%) and 27 left knees (54%) were included in the study. Mean age of the patients was 35 years (range 12 to 68 years); 37 patients were male (74%). ACL bundle anatomy was best depicted in the axial plane in 44 knees (88%) and in the coronal plane in six knees (12%). Two bundles were seen in 47 knees (94%). The AMB was completely seen in 45 knees (90%). The PLB was completely seen in 40 knees (80%). Both bundles were completely seen in 37 knees (76%). The double-bundle anatomy of the ACL is visualized in 94% of patients on 3T MRI. Because of potentially associated clinical benefits, we advocate to report separately on the anteromedial bundle and posterolateral bundle in case of anterior cruciate ligament injury of the knee. (orig.)

  11. Diagnostic usefulness of 3 tesla MRI of the brain for cushing disease in a child. (United States)

    Ono, Erina; Ozawa, Ayako; Matoba, Kaori; Motoki, Takanori; Tajima, Asako; Miyata, Ichiro; Ito, Junko; Inoshita, Naoko; Yamada, Syozo; Ida, Hiroyuki


    It is sometimes difficult to confirm the location of a microadenoma in Cushing disease. Recently, we experienced an 11-yr-old female case of Cushing disease with hyperprolactinemia. She was referred to our hospital because of decrease of height velocity with body weight gain. On admission, she had typical symptoms of Cushing syndrome. Although no pituitary microadenomas were detected on 1.5 Tesla MRI of the brain, endocrinological examinations including IPS and CS sampling were consistent with Cushing disease with hyperprolactinemia. Oral administration of methyrapone instead of neurosurgery was started after discharge, but subsequent 3 Tesla MRI of the brain clearly demonstrated a 3-mm less-enhanced lesion in the left side of the pituitary gland. Finally, transsphenoidal surgery was performed, and a 3.5-mm left-sided microadenoma was resected. Compared with 1.5 Tesla MRI, 3 Tesla MRI offers the advantage of a higher signal to noise ratio (SNR), which provides higher resolution and proper image quality. Therefore, 3 Tesla MRI is a very useful tool to localize microadenomas in Cushing disease in children as well as in adults. It will be the first choice of radiological examinations in suspected cases of Cushing disease.

  12. Three-dimensional isotropic fat-suppressed proton density-weighted MRI at 3 tesla using a T/R-coil can replace multiple plane two-dimensional sequences in knee imaging

    Energy Technology Data Exchange (ETDEWEB)

    Homsi, R.; Luetkens, J.A. [Bonn Univ. (Germany). Dept. of Radiology; Gieseke, J. [Philips Healthcare, Hamburg (Germany); and others


    To evaluate whether a 3D proton density-weighted fat-suppressed sequence (PDwFS) of the knee is able to replace multiplanar 2D-PDwFS. 52 patients (26 men, mean age: 41.9±14.5 years) underwent magnetic resonance imaging (MRI) of the knee at 3.0 Tesla using a T/R-coil. The imaging protocol included 3 planes of 2D-PDwFS (acquisition time (AT): 6:40 min; voxel sizes: 0.40-0.63 x 0.44-0.89 x 3 mm{sup 3}) and a 3D-PDwFS (AT: 6:31 min; voxel size: 0.63 x 0.68 x 0.63 mm{sup 3}). Homogeneity of fat suppression (HFS), artifacts, and image sharpness (IS) were evaluated on a 5-point scale (5[excellent] - 1[non-diagnostic]). The sum served as a measure for the overall image quality (OIQ). Contrast ratios (CR) compared to popliteal muscle were calculated for the meniscus (MEN), anterior (ACL) and posterior cruciate ligaments (PCL). In 13 patients who underwent arthroscopic knee surgery, two radiologists evaluated the presence of meniscal, ligamental and cartilage lesions to estimate the sensitivity and specificity of lesion detection. The CR was higher in the ACL, PCL and MEN in 3D- PDwFS compared to 2D-PDwFS (p<0.01 for ACL and PCL; p=0.07 for MEN). Compared to 2D images, the OIQ was rated higher in 3D-PDwFS images (p<0.01) due to fewer artifacts and HFS despite the lower IS (p<0.01). The sensitivity and specificity of lesion detection in 3D- and 2D-PDwFS were similar. Compared to standard multiplanar 2D-PDwFS knee imaging, isotropic high spatial resolution 3D-PDwFS of the knee at 3.0T can be acquired with high image quality in a reasonable scan time. Multiplanar reformations in arbitrary planes may serve as an additional benefit of 3D-PDwFS.

  13. Comparison of Quantitative Assessment of BLADE and Isotropic Three-Dimensional Fast Spin Echo Cube (3D T2 SPACE Sequences with Conventional Protocols of wrist Joint at 3 Tesla Magnetic Resonance Imaging

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    Full Text Available Background Magnetic resonance imaging (MRI of the wrist joint is a useful method in the diagnosis of triangular fibrocartilage complex (TFCC, ligaments and tendons, peripheral nerves, cartilage and carpal tunnel syndrome. However, the evaluation of these small anatomical structures is a topic of investigation. In some instances, the diagnostic indices of MRI in tears and other lesions of cartilage and ligamentous structures are relatively low, so the protocols should be optimized. Objectives In this study, we aim to compare new MRI protocols of 3D T2SPACE, PD BLADE and T2 BLADE with the conventional protocols, including T2 FSE, PD FSE, and T1 FSE in case of signal intensity. Patients and Methods Twenty patients with a history of wrist trauma or suspected wrist lesions were referred by orthopedic hand surgeons and enrolled into the study. All the protocols were carried out on all patients and the images were assessed quantitatively by measurement of signal to noise ratio (SNR and contrast to noise ratio (CNR. Then, these parameters were compared between different protocols. SPSS ver.18 was used for the statistical analyses. Results SNR of the cartilage, TFCC on 3D T2SPACE and T1 FSE was better than other sequences (P < 0.001. SNR of the bone on PD BLADE was significantly higher (P < 0.001 than that of conventional protocols. PD BLADE images showed significantly higher bone- cartilage CNR and bone- TFCC CNR (P < 0.001 to P < 0.001. CNR of cartilage-TFCC on T1 FSE was better than other sequences, but no significant statistical differences were seen. Conclusion High-resolution MR images of the wrist using 3D T2SPACE, PD BLADE and T2 BLADE were superior to those using conventional sequences quantitatively. High-SNR and CNR MR imaging with SPACE and BLADE would be a promising method to diagnose wrist lesions.

  14. Intraoperative 3-tesla MRI in the management of paediatric cranial tumours - initial experience

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    Avula, Shivaram; Garlick, Deborah; Abernethy, Laurence J. [Alder Hey Children' s NHS Foundation Trust, Department of Radiology, Liverpool (United Kingdom); Mallucci, Connor L. [Alder Hey Children' s Hospital, Department of Neurosurgery, Liverpool (United Kingdom); Pizer, Barry [Alder Hey Children' s Hospital, Department of Oncology, Liverpool (United Kingdom); Crooks, Daniel [Walton Centre for Neurology and Neurosurgery, Department of Pathology, Liverpool (United Kingdom)


    Intraoperative MRI (ioMRI) has been gaining recognition because of its value in the neurosurgical management of cranial tumours. There is limited documentation of its value in children. To review the initial experience of a paediatric 3-Tesla ioMRI unit in the management of cranial tumours. Thirty-eight children underwent ioMRI during 40 cranial tumour resections using a 3-Tesla MR scanner co-located with the neurosurgical operating theatre. IoMRI was performed to assess the extent of tumour resection and/or to update neuronavigation. The intraoperative and follow-up scans, and the clinical records were reviewed. In 27/40 operations, complete resection was intended. IoMRI confirmed complete resection in 15/27 (56%). As a consequence, surgical resection was extended in 5/27 (19%). In 6/27 (22%), ioMRI was equivocal for residual tumour. In 13/40 (33%) operations, the surgical aim was to partially resect the tumour. In 7 of the 13 (54%), surgical resection was extended following ioMRI. In our initial experience, ioMRI has increased the rate of complete resection, with intraoperative surgical strategy being modified in 30% of procedures. Collaborative analysis of ioMRI by the radiologist and neurosurgeon is vital to avoid errors in interpretation. (orig.)

  15. Early Choline Levels From 3-Tesla MR Spectroscopy After Exclusive Radiation Therapy in Patients With Clinically Localized Prostate Cancer are Predictive of Plasmatic Levels of PSA at 1 Year

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    Crehange, Gilles, E-mail: [Department of Radiation Oncology, Anticancer Centre Georges Francois Leclerc, Dijon (France); Maingon, Philippe [Department of Radiation Oncology, Anticancer Centre Georges Francois Leclerc, Dijon (France); Gauthier, Melanie [Biostatistics and Epidemiological Unit, EA 4184, Anticancer Centre Georges Francois Leclerc, Dijon (France); Parfait, Sebastien [LE2I, UMR 5158 CNRS, Universite de Bourgogne, Dijon (France); Cochet, Alexandre [Department of Magnetic Resonance Spectroscopy, Centre Hospitalier Universitaire, Dijon (France); Mirjolet, Celine [Department of Radiation Oncology, Anticancer Centre Georges Francois Leclerc, Dijon (France); Bonnetain, Franck [Biostatistics and Epidemiological Unit, EA 4184, Anticancer Centre Georges Francois Leclerc, Dijon (France); Cormier, Luc [Department of Urology, Centre Hospitalier Universitaire, Dijon (France); Brunotte, Francois; Walker, Paul [LE2I, UMR 5158 CNRS, Universite de Bourgogne, Dijon (France); Department of Magnetic Resonance Spectroscopy, Centre Hospitalier Universitaire, Dijon (France)


    clinical outcome for patients with or without LTHT.

  16. Orthodontic brackets in high field MR imaging: experimental evaluation of magnetic field interactions at 3.0 tesla; Kieferorthopaedische Brackets in der Hochfeld-Magnetresonanz-Tomographie: Experimentelle Beurteilung magnetischer Anziehungs- und Rotationskraefte bei 3 Tesla

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    Kemper, J.; Adam, G. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Eppendorf, Hamburg (Germany); Klocke, A.; Kahl-Nieke, B. [Poliklinik fuer Kieferorthopaedie, Universitaetsklinikum Eppendorf, Hamburg (Germany)


    Purpose: To evaluate static magnetic field interactions for 32 commonly used orthodontic brackets in a 3.0 T magnetic resonance imaging (MRI) system. Materials and methods: 32 orthodontic brackets consisting of a steel alloy (n=27), a cobalt-chromium alloy (n=2), ceramic (n=1), ceramic with a steel slot (n=1), and titanium (n=1) from 13 different manufacturers were tested for magnetic field interactions in a static magnetic field at 3.0 T (Gyroscan Intera 3.0 T, Philips Medical Systems, Best, Netherlands). The magnetic deflection force F{sub Z} [mN] was evaluated by determining the deflection angle {beta}[ ] using the established deflection angle test according to the ASTM guidelines. The magnetic-field-induced rotational force F{sub rot} or torque was qualitatively determined using a 5-point grading scale (0: no torque; +4: very strong torque). Results: In 18 of the 32 brackets, the deflection angle {beta} was found to be > 45 and the translational force exceeded the gravitational force F{sub G} on the particular bracket (F{sub Z}: 1.2-45.7 mN). The translational force F{sub Z} was found to be up to 68.5 times greater than the gravitational force F{sub G} (F{sub Z}/F{sub G}: 1.4-68.5). The rotational force F{sub rot} was correspondingly high (+3/+4) for those brackets. For the remaining 14 objects, the deflection angles were < 45 and the torque measurements ranged from 0 to +2. The static magnetic field did not affect the titanium bracket and the ceramic bracket. No measurable translational and rotational forces were found. (orig.)

  17. Flow-sensitive in-vivo 4D MR imaging at 3T for the analysis of aortic hemodynamics and derived vessel wall parameters; Die Analyse aortaler Haemodynamik und Gefaesswandparameter mittels fluss-sensitiver in-vivo 4D-MRT bei 3 Tesla

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    Frydrychowicz, A.; Markl, M.; Stalder, A.F.; Bock, J.; Bley, T.A.; Berger, A.; Russe, M.F.; Hennig, J.; Langer, M. [Freiburg Univ. (Germany). Abt. Roentgendiagnostik; Harloff, A. [Freiburg Univ. (Germany). Abt. Klinische Neurologie und Neurophysiologie; Schlensak, C. [Freiburg Univ. (Germany). Abt. Herz- und Gefaesschirurgie


    Modern phase contrast MR imaging at 3 Tesla allows the depiction of 3D morphology as well as the acquisition of time-resolved blood flow velocities in 3 directions. In combination with state-of-the-art visualization and data processing software, the qualitative and quantitative analysis of hemodynamic changes associated with vascular pathologies is possible. The 4D nature of the acquired data permits free orientation within the vascular system of interest and offers the opportunity to quantify blood flow and derived vessel wall parameters at any desired location within the data volume without being dependent on predefined 2D slices. The technique has the potential of overcoming the limitations of current diagnostic strategies and of implementing new diagnostic parameters. In light of the recent discussions regarding the influence of the wall shear stress and the oscillatory shear index on the genesis of arteriosclerosis and dilatative vascular processes, flow-sensitive 4D MRI may provide the missing diagnostic link. Instead of relying on experience-based parameters such as aneurysm size, new hemodynamic considerations can deepen our understanding of vascular pathologies. This overview reviews the underlying methodology at 3T, the literature on time-resolved 3D MR velocity mapping, and presents case examples. By presenting the pre- and postoperative assessment of hemodynamics in a thoracic aortic aneurysm and the detailed analysis of blood flow in a patient with coarctation we underline the potential of time-resolved 3D phase contrast MR at 3T for hemodynamic assessment of vascular pathologies, especially in the thoracic aorta. (orig.)

  18. Ventricular Assist Device implant (AB 5000 prototype cannula: In vitro assessment of MRI issues at 3-Tesla

    Directory of Open Access Journals (Sweden)

    Valencerina Samuel


    Full Text Available Abstract Purpose To evaluate MRI issues at 3-Tesla for a ventricular assist device (VAD. Methods The AB5000 Ventricle with a prototype Nitinol wire-reinforced In-Flow Cannula and Out-Flow Cannula attached (Abiomed, Inc., Danvers, MA was evaluated for magnetic field interactions, heating, and artifacts at 3-Tesla. MRI-related heating was assessed with the device in a gelled-saline-filled, head/torso phantom using a transmit/received RF body coil while performing MRI at a whole body averaged SAR of 3-W/kg for 15-min. Artifacts were assessed for the main metallic component of this VAD (atrial cannula using T1-weighted, spin echo and gradient echo pulse sequences. Results The AB5000 Ventricle with the prototype In-Flow Cannula and Out-Flow Cannula attached showed relatively minor magnetic field interactions that will not cause movement in situ. Heating was not excessive (highest temperature change, +0.8°C. Artifacts may create issues for diagnostic imaging if the area of interest is in the same area or close to the implanted metallic component of this VAD (i.e., the venous cannula. Conclusion The results of this investigation demonstrated that it would be acceptable for a patient with this VAD (AB5000 Ventricle with a prototype Nitinol wire-reinforced In-Flow Cannula and Out-Flow Cannula attached to undergo MRI at 3-Tesla or less. Notably, it is likely that the operation console for this device requires positioning a suitable distance (beyond the 100 Gauss line or in the MR control room from the 3-Tesla MR system to ensure proper function of the VAD.

  19. Optimizing texture measures quantifying bone structures as well as MR-sequences at 3 Tesla: an integrative statistical approach (United States)

    Raeth, Christoph W.; Mueller, Dirk; Rummeny, Ernst J.; Link, Thomas M.; Vogel, Mika; Koenig, Hartmut; Boehm, Holger; Monetti, Roberto


    High resolution MR-scanners working with magnetic field strengths of 3 Tesla are clinically available nowadays. They offer the possibility to obtain 3D images with unprecedented spatial resolution and/or signal-to-noise-ratio (SNR) allowing for an accurate visualization of the trabecular bone structure. It has been demonstrated that scaling indices are well suited to quantify these structures, especially to discriminate between plate-like and rod-like structural elements, which is crucial for the diagnosis of osteoporosis. Until now image quality has mainly been assessed by visual impression or by measures based on the SNR. In this work we present a methodology to assess different MR-sequences with respect to the texture measure that is used later in the image analysis. We acquired for a bone specimen HR-MR-sequences with different spatial resolution and signal to noise ratio. For these data sets we selected two volumes of interest (VOI) of same size located in the trabecular bone and in the background of the image. For both VOIs the scaling indices are calculated for different scale parameters. Subsequently the 'texture contrast' between structure and background is calculated by comparing the probability distributions of the scaling indices using a quadratic distance measure. By means of the contrast the optimal set of scale parameters is determined. By comparing the contrast for the different MR sequences the best suited ones are determined. It turns out that sequences with slightly lower spatial resolution but better signal to noise ration yield a better texture contrast than sequences with the best spatial resolution. The presented methodology offers the possibility to optimize simultaneously texture measures and MR-sequences, which will allow for an adapted and thus optimized analysis of image structures, e.g. trabecular bone, in the HR-MR data.

  20. High-resolution motion compensated MRA in patients with congenital heart disease using extracellular contrast agent at 3 Tesla

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    Dabir Darius


    Full Text Available Abstract Background Using first-pass MRA (FP-MRA spatial resolution is limited by breath-hold duration. In addition, image quality may be hampered by respiratory and cardiac motion artefacts. In order to overcome these limitations an ECG- and navigator-gated high-resolution-MRA sequence (HR-MRA with slow infusion of extracellular contrast agent was implemented at 3 Tesla for the assessment of congenital heart disease and compared to standard first-pass-MRA (FP-MRA. Methods 34 patients (median age: 13 years with congenital heart disease (CHD were prospectively examined on a 3 Tesla system. The CMR-protocol comprised functional imaging, FP- and HR-MRA, and viability imaging. After the acquisition of the FP-MRA sequence using a single dose of extracellular contrast agent the motion compensated HR-MRA sequence with isotropic resolution was acquired while injecting the second single dose, utilizing the timeframe before viability imaging. Qualitative scores for image quality (two independent reviewers as well as quantitative measurements of vessel sharpness and relative contrast were compared using the Wilcoxon signed-rank test. Quantitative measurements of vessel diameters were compared using the Bland-Altman test. Results The mean image quality score revealed significantly better image quality of the HR-MRA sequence compared to the FP-MRA sequence in all vessels of interest (ascending aorta (AA, left pulmonary artery (LPA, left superior pulmonary vein (LSPV, coronary sinus (CS, and coronary ostia (CO; all p  Conclusions An ECG- and navigator-gated HR-MRA-protocol with infusion of extracellular contrast agent at 3 Tesla is feasible. HR-MRA delivers significantly better image quality and vessel sharpness compared to FP-MRA. It may be integrated into a standard CMR-protocol for patients with CHD without the need for additional contrast agent injection and without any additional examination time.

  1. Resection and Resolution of Bone Marrow Lesions Associated with an Improvement of Pain after Total Knee Replacement: A Novel Case Study Using a 3-Tesla Metal Artefact Reduction MRI Sequence. (United States)

    Kurien, Thomas; Kerslake, Robert; Haywood, Brett; Pearson, Richard G; Scammell, Brigitte E


    We present our case report using a novel metal artefact reduction magnetic resonance imaging (MRI) sequence to observe resolution of subchondral bone marrow lesions (BMLs), which are strongly associated with pain, in a patient after total knee replacement surgery. Large BMLs were seen preoperatively on the 3-Tesla MRI scans in a patient with severe end stage OA awaiting total knee replacement surgery. Twelve months after surgery, using a novel metal artefact reduction MRI sequence, we were able to visualize the bone-prosthesis interface and found complete resection and resolution of these BMLs. This is the first reported study in the UK to use this metal artefact reduction MRI sequence at 3-Tesla showing that resection and resolution of BMLs in this patient were associated with an improvement of pain and function after total knee replacement surgery. In this case it was associated with a clinically significant improvement of pain and function after surgery. Failure to eradicate these lesions may be a cause of persistent postoperative pain that is seen in up to 20% of patients following TKR surgery.

  2. Variations of the posterior cerebral artery diagnosed by MR angiography at 3 tesla

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    Uchino, Akira; Saito, Naoko; Takahashi, Masahiro; Okano, Nanami; Tanisaka, Megumi [Saitama Medical University International Medical Center, Department of Diagnostic Radiology, Hidaka, Saitama (Japan)


    Fenestration, early bifurcation, and duplication of the posterior cerebral artery (PCA) and the so-called hyperplastic anterior choroidal artery (AChA), considered a variation of the PCA, are rare. We evaluated the prevalence and characteristic features of these PCA variations on magnetic resonance (MR) angiography. We reviewed intracranial MR angiographic images of 2402 patients examined using a 3-tesla scanner. Images from the skull base to the intracranial region were obtained using the standard time-of-flight technique. We excluded images of 52 patients with insufficient image quality or occlusion of the PCA(s) and retrospectively evaluated the images of 2350 patients using a picture archiving and communication system. We observed PCA fenestration in eight (0.34 %) patients, most at the P1 segment and P1-P2 junction and all small in size, early bifurcation at the P1-P2 junction or proximal P2A segment in eight (0.34 %) patients, complete duplication in one patient, and hyperplastic AChA in 13 (0.55 %) patients. Eleven of the 13 hyperplastic AChAs supplied only the territory of the temporal branch of the PCA, and the remaining two supplied the entire territory of the PCA. We observed PCA variations in 30 (1.28 %) patients. We believe the name ''hyperplastic AChA'' inaccurately describes variations of the PCA in which the AChA supplies part of or all of the territory of the PCA and propose ''accessory PCA'' to describe an AChA that supplies part of the territory of the PCA or ''replaced PCA'' to describe that vessel that supplies the territory all branches of the PCA. (orig.)

  3. Differentiation of brain metastases by percentagewise quantification of intratumoral-susceptibility-signals at 3 Tesla

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    Radbruch, Alexander, E-mail: [Department of Neuroradiology, University of Heidelberg Medical Center (Germany); Department of Radiology, German Cancer Research Center (DKFZ) (Germany); Graf, Markus, E-mail: [Software Development for Integrated Diagnosis and Therapy, German Cancer Research Center (DKFZ) (Germany); Kramp, Linda, E-mail: [Department of Neuroradiology, University of Heidelberg Medical Center (Germany); Wiestler, Benedikt, E-mail: [Department of Neurooncology, University of Heidelberg Medical Center (Germany); Floca, Ralf, E-mail: [Software Development for Integrated Diagnosis and Therapy, German Cancer Research Center (DKFZ) (Germany); Bäumer, Philipp, E-mail: [Department of Neuroradiology, University of Heidelberg Medical Center (Germany); Roethke, Matthias, E-mail: [Department of Radiology, German Cancer Research Center (DKFZ) (Germany); Stieltjes, Bram, E-mail: [Department of Radiology, German Cancer Research Center (DKFZ) (Germany); Schlemmer, Heinz-Peter, E-mail: [Department of Radiology, German Cancer Research Center (DKFZ) (Germany); Heiland, Sabine, E-mail: [Department of Neuroradiology, University of Heidelberg Medical Center (Germany); Bendszus, Martin, E-mail: [Department of Neuroradiology, University of Heidelberg Medical Center (Germany)


    Introduction: Evaluation of intratumoral-susceptibility-signals (ITSS) in susceptibility-weighted-imaging (SWI) has been reported to improve diagnostic performance for solitary enhancing brain lesions. Due to the distinct morphologic variability of ITSS, standardized evaluation proved to be difficult. We analyzed, if a new postprocessing method using percentagewise quantification (PQ) of ITSS enables differentiation between different entities of cerebral metastases and may thus improve differential diagnosis in cases of unknown primary. Materials and methods: SWI and contrast enhanced T1-weighted MR images were acquired from 84 patients with intracerebral metastases (20 patients with mamma carcinoma (MC), 15 patients with malignant melanoma (MM), 49 patients with bronchial carcinoma (BC)) at 3 Tesla MR. Images were co-registered and enhancing lesions were delineated on T1-weighted images and the outline transferred to the corresponding SWI map. All voxels within the lesion presenting values below a reference value placed in the ventricular system were determined and percentagewise calculated. Results: Diagnostic performance of percentagewise quantification (PQ) of ITSS, as determined with area under the receiver operating characteristic curve (AUC) was excellent (AUC = 0.96; 95% confidence interval (CI) 0.90, 1.00) to discriminate MM from MC, good for the discrimination of MM and BC (AUC = 0.81, 95% CI 0.70, 0.92) and poor for the discrimination of MC and BC (AUC = 0.60; 95% CI 0.47, 0.73). Conclusion: PQ is a new approach for the assessment of SWI that can be used for differential diagnosis of intracerebral metastases. Metastases of MM and MC or BC can be distinguished with high sensitivity and specificity.

  4. Cortical microinfarcts on 3T MRI : Clinical correlates in memory-clinic patients

    NARCIS (Netherlands)

    Van Veluw, Susanne J.; Hilal, Saima; Kuijf, Hugo J.; Ikram, Mohammad Kamran; Xin, Xu; Yeow, Tan Boon; Venketasubramanian, Narayanaswamy; Biessels, Geert Jan; Chen, Christopher


    Introduction This is the first study to assess cerebral microinfarcts (CMIs) on 3 tesla (3T) magnetic resonance imaging (MRI) in a memory clinic population. Methods We included 238 consecutive patients (aged 72.5 ± 9.1 years) from a memory clinic in Singapore. All patients underwent extensive neurol

  5. Vascular compression in glossopharyngeal neuralgia: demonstration by high-resolution MRI at 3 tesla

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    Fischbach, F.; Ricke, J.; Bruhn, H. [Department of Radiology, Charite, Campus Virchow Klinikum, Humboldt-University, Augustenburger Platz 1, 13352, Berlin (Germany); Lehmann, T.N. [Department of Neurosurgery, Charite, Campus Virchow Klinikum, Humboldt-University, Augustenberger Platz 1, 13353, Berlin (Germany)


    We report a case of glossopharyngeal neuralgia with vascular compression. High-resolution MRI at 3 tesla demonstrated the posterior inferior cerebellar artery to be closely related to the rootlets of the left glossopharyngeal nerve in a patient who suffered attacks of burning sensation in the left side of the throat. The MRI findings were confirmed at curative surgery. (orig.)

  6. Orbitofrontal lobe volume deficits in Antipsychotic-Naive schizophrenia: A 3-Tesla MRI study

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    Behere Rishikesh


    Full Text Available Background: Prefrontal cortex deficits have been consistently demonstrated in schizophrenia. The orbitofrontal lobe (OFL, a critical component of the prefrontal cortex, subserves social and neuro-cognitive functions. While these functional impairments are established in schizophrenia, the OFL volume deficits have not been well studied, especially in antipsychotic-naοve patients. Aim: To study OFL volume deficits in antipsychotic-naοve schizophrenia patients in comparison with matched healthy controls using high-resolution 3-tesla (3T magnetic resonance imaging (MRI. Materials and Methods: Fourteen antipsychotic-naοve schizophrenia patients (DSM-IV and 14 age-, sex-, handedness- and education-matched healthy controls were scanned using 3T MRI. Psychopathology was assessed in the patient group using the scale for assessment of negative symptoms and the scale for assessment of positive symptoms (SAPS. The OFL volume was measured using Region of Interest (ROI-based manual morphometry technique, with good inter-rater reliability (intra-class correlation coefficient = 0.98. Results: Total OFL volume was significantly smaller in schizophrenia patients (43.3 ± 9.6 mL in comparison with healthy controls (52.1 ± 12.2 mL after controlling for the potential confounding effects of age, sex and intracranial volume (F = 5.3, P = .03. Duration of untreated psychosis did not correlate significantly with OFL volumes. There was a trend towards significant negative correlation between the left and total OFL volumes and SAPS scores (r = -0.49, P = .06. Conclusion: OFL volume deficits might underlie the pathogenesis of schizophrenia symptoms with possible neuro-developmental origins.

  7. MRI at 3 Tesla detects no evidence for ischemic brain damage in intensively treated patients with homozygous familial hypercholesterolemia

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    Schmitz, Stephan A.; O' Regan, Declan P.; Fitzpatrick, Julie; Hajnal, Joseph V. [Hammersmith Hospital Campus, Imaging Sciences Department, MRC Clinical Sciences Centre, Faculty of Medicine, Imperial College, London (United Kingdom); Neuwirth, Clare; Potter, Elizabeth; Tosi, Isabella; Naoumova, Rossi P. [MRC Clinical Sciences Centre, Clinical Research Facility, London (United Kingdom); Hammersmith Hospital, Lipid Clinic, London (United Kingdom)


    Homozygous familial hypercholesterolemia (FH) is considered a model disease for excessive plasma cholesterol levels. Patients with untreated homozygous FH have a markedly increased risk for premature atherosclerosis. The frequency and extent of ischemic brain damage detectable by high-field magnetic resonance imaging (MRI) after long-term intensive treatment are unknown. In a case control study, five patients with homozygous FH (one male and four females; mean age: 23.6 {+-} 9.2, range: 12-36 years; mean pre-treatment serum total cholesterol level: 26.9 {+-} 3.24 mmol/L; all patients with documented atherosclerotic plaques in the carotid arteries) and five age- and sex-matched healthy controls were studied. All patients had been on maximal lipid-lowering medication since early childhood, and four of them were also on treatment with low-density lipoprotein (LDL) apheresis at bi-weekly intervals. Brain MRI was performed at 3 Tesla field strength with fluid-attenuated T2-weighted inversion recovery and T1-weighted spin-echo MR pulse sequences and subsequently evaluated by two independent readers. The maximal lipid-lowering treatment reduced the total serum cholesterol by more than 50% in the patients, but their serum concentrations were still 3.6-fold higher than those found in the controls (11.9 {+-} 4.2 vs. 4.5 {+-} 0.5 mmol/L; p < 0.0047). No brain abnormality was observed in any of the patients with homozygous FH. Homozygous FH patients on intensive cholesterol-lowering therapy have no evidence of ischemic brain damage at 3 Tesla MRI despite the remaining high cholesterol levels. (orig.)

  8. Diagnosis of rotator cuff tears using 3-Tesla MRI versus 3-Tesla MRA: a systematic review and meta-analysis

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    McGarvey, Ciaran; Harb, Ziad; Smith, Christian; Ajuied, Adil [Guy' s and St Thomas' Hospital, King' s Health Partners, Department of Trauma and Orthopaedics, London (United Kingdom); Houghton, Russell [Guy' s and St Thomas' Hospital, King' s Health Partners, Department of Radiology, London (United Kingdom); Corbett, Steven [Guy' s and St Thomas' Hospital, King' s Health Partners, Department of Trauma and Orthopaedics, London (United Kingdom); Fortius Clinic, London (United Kingdom)


    To compare the diagnostic accuracy of magnetic resonance imaging (MRI), 2-dimensional magnetic resonance arthrogram (MRA) and 3-dimensional isotropic MRA in the diagnosis of rotator cuff tears when performed exclusively at 3-T. A systematic review was undertaken of the Cochrane, MEDLINE and PubMed databases in accordance with the PRISMA guidelines. Studies comparing 3-T MRI or 3-T MRA (index tests) to arthroscopic surgical findings (reference test) were included. Methodological appraisal was performed using QUADAS 2. Pooled sensitivity and specificity were calculated and summary receiver-operating curves generated. Kappa coefficients quantified inter-observer reliability. Fourteen studies comprising 1332 patients were identified for inclusion. Twelve studies were retrospective and there were concerns regarding index test bias and applicability in nine and six studies respectively. Reference test bias was a concern in all studies. Both 3-T MRI and 3-T MRA showed similar excellent diagnostic accuracy for full-thickness supraspinatus tears. Concerning partial-thickness supraspinatus tears, 3-T 2D MRA was significantly more sensitive (86.6 vs. 80.5 %, p = 0.014) but significantly less specific (95.2 vs. 100 %, p < 0.001). There was a trend towards greater accuracy in the diagnosis of subscapularis tears with 3-T MRA. Three-Tesla 3D isotropic MRA showed similar accuracy to 3-T conventional 2D MRA. Three-Tesla MRI appeared equivalent to 3-T MRA in the diagnosis of full- and partial-thickness tears, although there was a trend towards greater accuracy in the diagnosis of subscapularis tears with 3-T MRA. Three-Tesla 3D isotropic MRA appears equivalent to 3-T 2D MRA for all types of tears. (orig.)

  9. Assessment of MRI Issues at 3 Tesla for a New Metallic Tissue Marker. (United States)

    Cronenweth, Charlotte M; Shellock, Frank G


    Purpose. To assess the MRI issues at 3 Tesla for a metallic tissue marker used to localize removal areas of tissue abnormalities. Materials and Methods. A newly designed, metallic tissue marker (Achieve Marker, CareFusion, Vernon Hills, IL) used to mark biopsy sites, particularly in breasts, was assessed for MRI issues which included standardized tests to determine magnetic field interactions (i.e., translational attraction and torque), MRI-related heating, and artifacts at 3 Tesla. Temperature changes were determined for the marker using a gelled-saline-filled phantom. MRI was performed at a relatively high specific absorption rate (whole body averaged SAR, 2.9-W/kg). MRI artifacts were evaluated using T1-weighted, spin echo and gradient echo pulse sequences. Results. The marker displayed minimal magnetic field interactions (2-degree deflection angle and no torque). MRI-related heating was only 0.1°C above background heating (i.e., the heating without the tissue marker present). Artifacts seen as localized signal loss were relatively small in relation to the size and shape of the marker. Conclusions. Based on the findings, the new metallic tissue marker is acceptable or "MR Conditional" (using current labeling terminology) for a patient undergoing an MRI procedure at 3 Tesla or less.

  10. 3D calculations of the Superconducting Super Collider (SSC) 3 Tesla magnet

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    Lari, R.J.


    A 20 TeV Superconducting Super Collider (SSC) proton accelerator is being proposed by the High Energy Physics Community. One proposal would consist of a ring of magnets 164 km in circumference with a field strength of 3 Tesla and would cost 2.7 billion dollars. The magnet consists of stacked steel laminations with superconducting coils. The desired field uniformity is obtained for all fields from 0.2 to 3 Tesla by using three (or more) different pole shapes. These three different laminations are stacked in the order 1-2-3-1-2-3-... creating a truly three dimensional geometry. A three laminated stack 1-2-3 with periodic boundary conditions at 1 and 3 was assigned about 5000 finite elements per lamination and solved using the computer program TOSCA. To check the TOSCA results, the field of each of the three different shaped laminations was calculated separately using periodic boundary conditions and compared to the two dimensional field calculations using TRIM. This was done for a constant permeability of 2000 and using the B-H table for fully annealed 1010 steel. The difference of the field calculations in the region of interest was always less than +-.2%

  11. Comparison of whole body MR angiography at 1.5 and 3 Tesla in patients with hereditary hyperlipidemia

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    Bannas, Peter; Finck-Wedel, Anna Katharina; Buhk, Jan-Hendrik; Bley, Thorsten Alexander; Koops, Andreas; Adam, Gerhard; Weber, Christoph (Dept. of Diagnostic and Interventional Radiology, Univ. Hospital Hamburg-Eppendorf, Hamburg (Germany)), email:; Kooijman, Hendrik (Philips Medical Systems, Hamburg (Germany)); Beil, Frank-Ulrich (Dept. of Internal Medicine, Univ. Hospital Hamburg-Eppendorf, Hamburg (Germany))


    Background Patients suffering from hereditary hyperlipidemia have a high risk for premature cardiovascular disease and death as a consequence of accelerated atherosclerosis. Purpose To prospectively and intra-individually compare image quality and detectability of stenoses in contrast enhanced whole-body MRA (WBMRA) at 1.5 and 3 Tesla (T) in patients with hereditary hyperlipidemia. Material and Methods Twenty-seven patients with hereditary hyperlipidemia received a 1.5 and 3 T gadopentetate dimeglumine contrast-enhanced WBMRA. Twenty-three defined arterial segments were analyzed regarding depiction of target vessels and image quality according to a 5-point-scale ('not evaluable' to 'excellent'). Wilcoxon matched pair test was performed for comparison. Forty-three defined arterial segments were analyzed for the degree of stenosis (0%, 1-49%, 50-99% and 100%) as well as vessel alterations such as aneurysms. Chi-square test was performed for comparison. Results 1.5 T and 3 T scans yielded WBMRA with diagnostic quality in all patients. In seven of 23 arterial segments (30.4%) image quality was rated significantly higher at 3 T, whereas there was no significant difference in the remaining 16 segments between WBMRA at 1.5 T and 3 T. All relevant stenoses (n = 5), occlusions (n = 6), and aneurysms (n = 3) were evaluated similarly at both field strengths. Conclusion WBMRA can be performed at 1.5 T and 3 T with diagnostic image quality. Image quality was significantly higher at 3 T than at 1.5 T in only 30.4% of the arterial segments. In order to effectively take advantage of the higher field strength, further optimization of sequence parameters and injection protocols for WBMRA at 3 T is necessary

  12. An in vitro assessment of MRI issues at 3-Tesla for antimicrobial, silver-containing wound dressings. (United States)

    Escher, Kirin B; Shellock, Frank G


    Although no reports of adverse events have been published to date, the presence of metallic dressing ingredients may present an magnetic resonance imaging (MRI) safety concern for patients using silver-containing wound dressings. The purpose of this in vitro study was to test magnetic field interactions (ie, translational attraction and torque), heating, artifacts, and conductivity (ie, electrical resistance) when using MRI at 3-Tesla for two (nonborder and border) silver-containing wound dressings. The results indicated the dressings displayed no magnetic field interactions (deflection angle 0˚; no torque), and in each case, MRI-related heating effects were at the same levels as the background temperature increases (ie, <1.8˚C). The dressings created extremely subtle artifacts (one-for-one relationship) on the MR images. With regard to the conductivity assessments, the average resistance values were 20 kOhm and 1.1 kOhm, respectively, for the nonborder and border wound dressings, which were acceptable levels. The findings show the two silver-containing wound dressings tested will not pose hazards or risks to patients and, thus, are considered "MR safe" according to the current labeling terminology used for medical products, and each dressing may be left in place when a patient undergoes an MRI examination. To date, only a hydrofiber silver-containing dressing has been tested for MRI safety. Because of potential variances in material characteristics, MRI test results are specific to the dressings tested and cannot be applied to other products. Future studies to define the level of silver concentration in dressings that may pose a hazard for performing an MRI are warranted.

  13. Nonenhanced magnetic resonance angiography (MRA) of the calf arteries at 3 Tesla: intraindividual comparison of 3D flow-dependent subtractive MRA and 2D flow-independent non-subtractive MRA

    Energy Technology Data Exchange (ETDEWEB)

    Knobloch, Gesine; Lauff, Marie-Teres; Hirsch, Sebastian; Hamm, Bernd; Wagner, Moritz [Charite - Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany); Schwenke, Carsten [SCO:SSiS Statistical Consulting, Berlin (Germany)


    To prospectively compare 3D flow-dependent subtractive MRA vs. 2D flow-independent non-subtractive MRA for assessment of the calf arteries at 3 Tesla. Forty-two patients with peripheral arterial occlusive disease underwent nonenhanced MRA of calf arteries at 3 Tesla with 3D flow-dependent subtractive MRA (fast spin echo sequence; 3D-FSE-MRA) and 2D flow-independent non-subtractive MRA (balanced steady-state-free-precession sequence; 2D-bSSFP-MRA). Moreover, all patients underwent contrast-enhanced MRA (CE-MRA) as standard-of-reference. Two readers performed a per-segment evaluation for image quality (4 = excellent to 0 = non-diagnostic) and severity of stenosis. Image quality scores of 2D-bSSFP-MRA were significantly higher compared to 3D-FSE-MRA (medians across readers: 4 vs. 3; p < 0.0001) with lower rates of non-diagnostic vessel segments on 2D-bSSFP-MRA (reader 1: <1 % vs. 15 %; reader 2: 1 % vs. 29 %; p < 0.05). Diagnostic performance of 2D-bSSFP-MRA and 3D-FSE-MRA across readers showed sensitivities of 89 % (214/240) vs. 70 % (168/240), p = 0.0153; specificities: 91 % (840/926) vs. 63 % (585/926), p < 0.0001; and diagnostic accuracies of 90 % (1054/1166) vs. 65 % (753/1166), p < 0.0001. 2D flow-independent non-subtractive MRA (2D-bSSFP-MRA) is a robust nonenhanced MRA technique for assessment of the calf arteries at 3 Tesla with significantly higher image quality and diagnostic accuracy compared to 3D flow-dependent subtractive MRA (3D-FSE-MRA). (orig.)

  14. 3 Tesla multiparametric MRI for GTV-definition of Dominant Intraprostatic Lesions in patients with Prostate Cancer – an interobserver variability study (United States)


    Purpose To evaluate the interobserver variability of gross tumor volume (GTV) - delineation of Dominant Intraprostatic Lesions (DIPL) in patients with prostate cancer using published MRI criteria for multiparametric MRI at 3 Tesla by 6 different observers. Material and methods 90 GTV-datasets based on 15 multiparametric MRI sequences (T2w, diffusion weighted (DWI) and dynamic contrast enhanced (DCE)) of 5 patients with prostate cancer were generated for GTV-delineation of DIPL by 6 observers. The reference GTV-dataset was contoured by a radiologist with expertise in diagnostic imaging of prostate cancer using MRI. Subsequent GTV-delineation was performed by 5 radiation oncologists who received teaching of MRI-features of primary prostate cancer before starting contouring session. GTV-datasets were contoured using Oncentra Masterplan® and iplan® Net. For purposes of comparison GTV-datasets were imported to the Artiview® platform (Aquilab®), GTV-values and the similarity indices or Kappa indices (KI) were calculated with the postulation that a KI > 0.7 indicates excellent, a KI > 0.6 to 0.5 to < 0.6 moderate agreement. Additionally all observers rated difficulties of contouring for each MRI-sequence using a 3 point rating scale (1 = easy to delineate, 2 = minor difficulties, 3 = major difficulties). Results GTV contouring using T2w (KI-T2w = 0.61) and DCE images (KI-DCE = 0.63) resulted in substantial agreement. GTV contouring using DWI images resulted in moderate agreement (KI-DWI = 0.51). KI-T2w and KI-DCE was significantly higher than KI-DWI (p = 0.01 and p = 0.003). Degree of difficulty in contouring GTV was significantly lower using T2w and DCE compared to DWI-sequences (both p < 0.0001). Analysis of delineation differences revealed inadequate comparison of functional (DWI, DCE) to anatomical sequences (T2w) and lack of awareness of non-specific imaging findings as a source of erroneous delineation. Conclusions Using T

  15. Clinical imaging of the pancreas

    Energy Technology Data Exchange (ETDEWEB)

    May, G.; Gardiner, R.


    Featuring more than 300 high-quality radiographs and scan images, clinical imaging of the pancreas systematically reviews all appropriate imaging modalities for diagnosing and evaluating a variety of commonly encountered pancreatic disorders. After presenting a succinct overview of pancreatic embryology, anatomy, and physiology, the authors establish the clinical indications-including postoperative patient evaluation-for radiologic examination of the pancreas. The diagnostic capabilities and limitations of currently available imaging techniques for the pancreas are thoroughly assessed, with carefully selected illustrations depicting the types of images and data obtained using these different techniques. The review of acute and chronic pancreatitis considers the clinical features and possible complications of their variant forms and offers guidance in selecting appropriate imaging studies.

  16. Clinical photoacoustic imaging of cancer

    Directory of Open Access Journals (Sweden)

    Keerthi S. Valluru


    Full Text Available Photoacoustic imaging is a hybrid technique that shines laser light on tissue and measures optically induced ultrasound signal. There is growing interest in the clinical community over this new technique and its possible clinical applications. One of the most prominent features of photoacoustic imaging is its ability to characterize tissue, leveraging differences in the optical absorption of underlying tissue components such as hemoglobin, lipids, melanin, collagen and water among many others. In this review, the state-of-the-art photoacoustic imaging techniques and some of the key outcomes pertaining to different cancer applications in the clinic are presented.

  17. Clinical photoacoustic imaging of cancer. (United States)

    Valluru, Keerthi S; Willmann, Juergen K


    Photoacoustic imaging is a hybrid technique that shines laser light on tissue and measures optically induced ultrasound signal. There is growing interest in the clinical community over this new technique and its possible clinical applications. One of the most prominent features of photoacoustic imaging is its ability to characterize tissue, leveraging differences in the optical absorption of underlying tissue components such as hemoglobin, lipids, melanin, collagen and water among many others. In this review, the state-of-the-art photoacoustic imaging techniques and some of the key outcomes pertaining to different cancer applications in the clinic are presented.

  18. Clinical photoacoustic imaging of cancer

    Energy Technology Data Exchange (ETDEWEB)

    Valluru, Keerthi S.; Willmann, Juergen K. [Dept. of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford (United States)


    Photoacoustic imaging is a hybrid technique that shines laser light on tissue and measures optically induced ultrasound signal. There is growing interest in the clinical community over this new technique and its possible clinical applications. One of the most prominent features of photoacoustic imaging is its ability to characterize tissue, leveraging differences in the optical absorption of underlying tissue components such as hemoglobin, lipids, melanin, collagen and water among many others. In this review, the state-of-the-art photoacoustic imaging techniques and some of the key outcomes pertaining to different cancer applications in the clinic are presented.

  19. Clinical photoacoustic imaging of cancer (United States)


    Photoacoustic imaging is a hybrid technique that shines laser light on tissue and measures optically induced ultrasound signal. There is growing interest in the clinical community over this new technique and its possible clinical applications. One of the most prominent features of photoacoustic imaging is its ability to characterize tissue, leveraging differences in the optical absorption of underlying tissue components such as hemoglobin, lipids, melanin, collagen and water among many others. In this review, the state-of-the-art photoacoustic imaging techniques and some of the key outcomes pertaining to different cancer applications in the clinic are presented. PMID:27669961

  20. Customization of normal data base specific for 3-tesla MRI is mandatory in VSRAD analysis. (United States)

    Goto, Masami; Suzuki, Yuuichi; Abe, Osamu; Hayashi, Naoto; Aoki, Shigeki; Mori, Harushi; Masumoto, Tomohiko; Watanabe, Yasushi; Satake, Yoshirou; Ino, Kenji; Yano, Keiichi; Iida, Kyouhito; Mima, Kazuo; Ohtomo, Kuni


    A voxel-based specific regional analysis system for Alzheimer's disease (VSRAD) was used for quantitative analysis of parahippocampal atropy with 1.5-tesla (T) MRI in a voxel-wise manner. The analysis of images acquired under a different imaging condition provides an error factor that has a calculated value. Clinical application of 3T-MRI is necessary for establishing a normal data base (N-DB) specific for 3T-MRI data, which permits appropriate application of VSRAD. We established an N-DB specific for 3T-MRI for use in VSRAD. The "Z-score of the parahippocampal gyrus" was 0.79 +/- 0.32, and the N-DB of each age group did not have a big deflection when we analyzed a group of physically unimpaired persons in an N-DB specific for 3T-MRI. Therefore, we were able to confirm the validity of the customized N-DB. The "Z-score of the parahippocampal gyrus" was 1.62 +/- 0.47 for the N-DB of VSRAD. The numerical value was high for the group of physically unimpaired persons.

  1. Quantitative assessment of right ventricular function and pulmonary regurgitation in surgically repaired tetralogy of Fallot using 256-slice CT: comparison with 3-Tesla MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yamasaki, Yuzo; Yonezawa, Masato; Matsuo, Yoshio; Kamitani, Takeshi; Higuchi, Ko; Honda, Hiroshi [Graduate School of Medical Sciences, Kyushu University, Department of Clinical Radiology, Higashi-ku, Fukuoka (Japan); Nagao, Michinobu; Kawanami, Satoshi [Graduate School of Medical Sciences, Kyushu University, Department of Molecular Imaging and Diagnosis, Higashi-ku, Fukuoka (Japan); Yamamura, Kenichiro [Graduate School of Medical Sciences, Kyushu University, Department of Pediatrics, Higashi-ku, Fukuoka (Japan); Sakamoto, Ichiro [Graduate School of Medical Sciences, Kyushu University, Department of Cardiovascular Medicine, Higashi-ku, Fukuoka (Japan); Shiokawa, Yuichi [Graduate School of Medical Sciences, Kyushu University, Department of Cardiovascular Surgery, Higashi-ku, Fukuoka (Japan); Yabuuchi, Hidetake [Graduate School of Medical Sciences, Kyushu University, Department of Health Sciences, Higashi-ku, Fukuoka (Japan)


    To compare 256-slice cardiac computed tomography (CCT) with cardiac magnetic resonance (CMR) imaging to assess right ventricular (RV) function and pulmonary regurgitant fraction (PRF) in patients with repaired tetralogy of Fallot (TOF). Thirty-three consecutive patients with repaired TOF underwent retrospective ECG-gated CCT and 3-Tesla CMR. RV and left ventricular (LV) end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF) were measured using CCT and CMR. PRF-CCT (%) was defined as (RVSV - LVSV)/RVSV. PRF-CMR (%) was measured by the phase-contrast method. Repeated measurements were performed to determine intra- and interobserver variability. CCT measurements, including PRF, correlated highly with the CMR reference (r = 0.71-0.96). CCT overestimated RVEDV (mean difference, 17.1 ± 2.9 ml), RVESV (12.9 ± 2.1 ml) and RVSV (4.2 ± 2.0 ml), and underestimated RVEF (-2.6 ± 1.0 %) and PRF (-9.1 ± 2.0 %) compared with CMR. The limits of agreement between CCT and CMR were in a good range for all measurements. The variability in CCT measurements was lower than those in CMR. The estimated effective radiation dose was 7.6 ± 2.6 mSv. 256-slice CCT can assess RV function and PRF with relatively low dose radiation exposure in patients with repaired TOF, but overestimates RV volume and underestimates PRF. (orig.)

  2. Clinical Role of Hybrid Imaging. (United States)

    Hsiao, Edward M; Ali, Bilal; Dorbala, Sharmila


    Recent technological advances have fueled the growth in hybrid radionuclide and CT imaging of the heart. Noninvasive imaging studies are reliable means to diagnose coronary artery disease (CAD), stratify risk, and guide clinical management. Myocardial perfusion scintigraphy is a robust, widely available noninvasive modality for the evaluation of ischemia from known or suspected CAD. Cardiac CT (coronary artery calcium score and coronary CT angiography) has emerged as a clinically robust noninvasive anatomic imaging test, capable of rapidly diagnosing or excluding obstructive CAD. Both anatomic and functional modalities have strengths and weaknesses, and can complement each other by offering integrated structural and physiologic information. As we discuss below, in selected patients, hybrid imaging may facilitate more accurate diagnosis, risk stratification, and management in a "one-stop shop" setting.

  3. CCCT - NCTN Steering Committees - Clinical Imaging (United States)

    The Clinical Imaging Steering Committee serves as a forum for the extramural imaging and oncology communities to provide strategic input to the NCI regarding its significant investment in imaging activities in clinical trials.

  4. First test of a power-pulsed electronics system on a GRPC detector in a 3-Tesla magnetic field

    CERN Document Server

    Caponetto, L; de la Taille, C; Dulucq, F; Kieffer, R; Laktineh, I; Lumb, N; Mirabito, L; Seguin-Moreau, N


    An important technological step towards the realization of an ultra-granular hadronic calorimeter to be used in the future International Linear Collider (ILC) experiments has been made. A 33X50 cm2 GRPC detector equipped with a power-pulsed electronics board offering a 1cm2 lateral segmentation was successfully tested in a 3-Tesla magnet operating at the H2 beam line of the CERN SPS. An important reduction of power consumption with no deterioration of the detector performance is obtained when the power-pulsing mode is applied. This important result shows that ultra-granular calorimeters for ILC experiments are not only an attractive but also a realistic option.

  5. Measurement of coronary flow response to cold pressor stress in asymptomatic women with cardiovascular risk factors using spiral velocity-encoded cine MRI at 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Maroules, Christopher D.; Peshock, Ronald M. (Dept. of Radiology, Univ. of Texas Southwestern Medical Center, Dallas, TX (United States)), e-mail:; Chang, Alice Y.; Kontak, Andrew (Dept. of Internal Medicine, Univ. of Texas Southwestern Medical Center, Dallas, TX (United States)); Dimitrov, Ivan; Kotys, Melanie (Dept. of Philips Medical Systems, Cleveland, OH (United States))


    Background: Coronary sinus (CS) flow in response to a provocative stress has been used as a surrogate measure of coronary flow reserve, and velocity-encoded cine (VEC) magnetic resonance imaging (MRI) is an established technique for measuring CS flow. In this study, the cold pressor test (CPT) was used to measure CS flow response because it elicits an endothelium-dependent coronary vasodilation that may afford greater sensitivity for detecting early changes in coronary endothelial function. Purpose: To investigate the feasibility and reproducibility of CS flow reactivity (CSFR) to CPT using spiral VEC MRI at 3 Tesla in a sample of asymptomatic women with cardiovascular risk factors. Material and Methods: Fourteen asymptomatic women (age 38 years +- 10) with cardiovascular risk factors were studied using 3D spiral VEC MRI of the CS at 3 T. The CPT was utilized as a provocative stress to measure changes in CS flow. CSFR to CPT was calculated from the ratio of CS flow during peak stress to baseline CS flow. Results: CPT induced a significant hemodynamic response as measured by a 45% increase in rate-pressure product (P<0.01). A significant increase in CS volume flow was also observed (baseline, 116 +- 26 ml/min; peak stress, 152 +- 34 ml/min, P=0.01). CSFR to CPT was 1.31 +- 0.20. Test-retest variability of CS volume flow was 5% at baseline and 6% during peak stress. Conclusion: Spiral CS VEC MRI at 3 T is a feasible and reproducible technique for measuring CS flow in asymptomatic women at risk for cardiovascular disease. Significant changes in CSFR to CPT are detectable, without demanding pharmacologic stress

  6. Clinics in diagnostic imaging (171) (United States)

    Ooi, Su Kai Gideon; Tan, Tien Jin; Ngu, James Chi Yong


    A 46-year-old Chinese woman with a history of cholecystectomy and appendicectomy presented to the emergency department with symptoms of intestinal obstruction. Physical examination revealed central abdominal tenderness but no clinical features of peritonism. Plain radiography of the abdomen revealed a grossly distended large bowel loop with the long axis extending from the right lower abdomen toward the epigastrium, and an intraluminal air-fluid level. These findings were suspicious for an acute caecal volvulus, which was confirmed on subsequent contrast-enhanced computed tomography (CT) of the abdomen and pelvis. CT demonstrated an abnormal positional relationship between the superior mesenteric vein and artery, indicative of an underlying intestinal malrotation. This case highlights the utility of preoperative imaging in establishing the diagnosis of an uncommon cause of bowel obstruction. It also shows the importance of recognising the characteristic imaging features early, so as to ensure appropriate and expedient management, thus reducing patient morbidity arising from complications. PMID:27872936

  7. Evaluation of Iron Deposition in the Adrenal Glands of β Thalassemia Major Patients Using 3-Tesla MRI

    Directory of Open Access Journals (Sweden)



    Full Text Available Background Beta-thalassemia major (β-TM patients need blood transfusions, which result in iron deposition. To regulate chelation therapy, iron load has to be measured. With MRI, the amount of signal loss and T2* decay time shortening are used for iron quantification. Objectives The aim was to measure adrenal iron load with T2* relaxometry using MRI, and to compare it with liver and cardiac iron and serum ferritin, and to find out whether adrenal iron could be predicted from those parameters. Patients and Methods Between October 2014 and March 2015, MRI was performed in 21 patients with β-TM, recieving blood transfusions and chelation therapy. The control group (n = 11 included healthy volunteers with no known history of adrenal, hematologic, chronic disease, and blood transfusion. Results Among patients, there was no significant correlation between plasma ferritin and adrenal T2*. Significant difference was detected among T2* values of adrenals between the patient and control groups. There was no significant correlation between adrenal gland and liver T2* in β-TM patients, moderate correlation was detected between adrenal T2* and cardiac T2*. Conclusion Adrenal iron in β-TM can be reliably measured in 3 Tesla MRI. The results highlight the absence of correlation between adrenal iron deposition both with serum ferritin and hepatic iron.

  8. Inferior parietal lobule volume and schneiderian first-rank symptoms in Antipsychotic-Naive schizophrenia: A 3-Tesla MRI study

    Directory of Open Access Journals (Sweden)

    Danivas Vijay


    Full Text Available Background: As per Frith′s neuro-cognitive model, inferior parietal lobule (IPL is implicated in the pathogenesis of Schneiderian first-rank symptoms (FRS in schizophrenia. The specific role of IPL structural abnormalities in the pathogenesis of FRS is yet to be ascertained. Materials and Methods: Using 3-tesla MRI scanner, this first-time study examined antipsychotic-naοve schizophrenia patients ( n = 28 (patients with FRS [FRS +]: N = 14, M: F = 7:7; and patients without FRS [FRS-]: N = 14, M: F = 7:7 in comparison with sex-, handedness-, education- and socioeconomic status-matched healthy controls ( n = 14, M: F = 7:7. The volume of IPL was measured using a three-dimensional, interactive, semi-automated analysis, with good inter-rater reliability. Results: FRS + patients showed significant volume deficit in right IPL in comparison with healthy controls (F = 4.0; P=.028 after controlling for the potential confounding effects of age, sex and intracranial volume. Conclusions: Right IPL volume deficit in FRS+patients adds further support to the Frith′s model of FRS in schizophrenia.

  9. Dilated perivascular spaces and fatigue: is there a link? Magnetic resonance retrospective 3Tesla study

    Energy Technology Data Exchange (ETDEWEB)

    Conforti, Renata; Cirillo, Mario; Sardaro, Angela; Negro, Alberto; Cirillo, Sossio [Second University of Naples, Neuroradiology Service, Department of Radiology, Naples (Italy); Caiazzo, Giuseppina; Paccone, Antonella [Second University of Naples, MRI Research Center SUN-FISM, Naples (Italy); Sacco, Rosaria; Sparaco, Maddalena; Gallo, Antonio; Lavorgna, Luigi; Tedeschi, Gioacchino [Second University of Naples, Department of Neurology, Naples (Italy)


    Fatigue (F) is a common, inexplicable, and disabling symptom in multiple sclerosis (MS) patients. The purpose of this study was to evaluate a possible correlation between fatigue and morpho-volumetric features and site of dilated perivascular spaces (dPS), visible on 3T magnetic resonance (MR) in fatigued multiple sclerosis patients (FMS). We studied 82 relapsing remitting (RR) FMS patients and 43 HC, matched for age, sex, and education. F was assessed by the Fatigue Severity Scale (FSS). To evaluate a possible correlation between degree of F and characteristics of dPS, patients were divided in two groups: more (mFMS) (FSS ≥ 5; n = 30) and less fatigued (lFMS) (FSS ≥ 4; n = 52), compared to a matched healthy control (HC) subject group. The MR study was performed with 3T scanner by SpinEcho T1, Fast-SpinEcho DP-T2, FLAIR, and 3D FSPGR T1 sequences. dPS volumes were measured with Medical Image Processing Analysis and Visualization (MIPAV); Global Cerebral Atrophy (GCA), expressed as Brain Parenchymal Fraction (BPF), was assessed by FSL SIENAX. The t test showed significantly increased dPS number (p = 0.021) in FMS patients (mFMS p = 0.0024 and lFMS p = 0.033) compared to HC. Pearson correlation revealed a significant correlation between dPS number and FSS (r = 0.208 p = 0.051). Furthermore, the chi-squared test confirms the intragroup (HC, mFMS, lFMS) differences about dPS location (p = 0.01) and size (p = 0.0001). Our study confirms that PS in MS patients presents with different volumetric and site characteristics as compared to HC; moreover, F severity significantly correlates with dPS number, site, and size. (orig.)

  10. Acute inversion injury of the ankle without radiological abnormalities: assessment with high-field MR imaging and correlation of findings with clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Langner, Inga; Frank, Matthias; Hinz, Peter; Ekkernkamp, Axel [Ernst-Moritz-Arndt-University Greifswald, Department of Trauma and Orthopedic Surgery, Emergency Department, Greifswald (Germany); Kuehn, Jens Peter; Hosten, Norbert; Langner, Soenke [Ernst-Moritz-Arndt-University Greifswald, Institute for Diagnostic Radiology and Neuroradiology, Greifswald (Germany)


    Acute inversion injuries of the ankle are the most common sports accidents, accounting for approximately 10% of emergency room admissions. In up to 85%, an injury of the lateral collateral ligaments is observed. Classically, the assessment of these injuries has relied on clinical examination and radiographs, including stress views. The aim of our study was to correlate prospectively the findings of high-field 3 T MRI in acute ankle distortion with clinical outcome. During a 6-month period, 38 patients were prospectively included. MRI was performed within 48 h of trauma and clinical examination using a protocol consisting of axial T2-weighted and coronal and sagittal T1-weighted images and a sagittal proton density (PDw) sequence. Each ligament injury was graded on a three-point scale. Functional outcome was evaluated using the AOFAS ankle-hindfoot scale. In 24/38 patients (63.12%), ligament injury was observed. In 22/24 cases, this was an injury of the lateral ligaments and in 2/24 cases of the medial ligaments. Injury of the syndesmosis occurred in three patients, a bone bruise in four, and an osteochondral lesion in three cases. Patients with an injury of two or more ligaments or a bone bruise had a lower AOFAS score and returned to sports activities and full weight-bearing later (P < 0.01). MR imaging at 3 Tesla is an independent predictor for clinical outcome. Therefore MRI may be beneficial in those cases where the findings influence further treatment. (orig.)

  11. Ultrasound molecular imaging: Moving toward clinical translation

    Energy Technology Data Exchange (ETDEWEB)

    Abou-Elkacem, Lotfi; Bachawal, Sunitha V.; Willmann, Jürgen K., E-mail:


    Highlights: • Ultrasound molecular imaging is a highly sensitive modality. • A clinical grade ultrasound contrast agent has entered first in human clinical trials. • Several new potential future clinical applications of ultrasound molecular imaging are being explored. - Abstract: Ultrasound is a widely available, cost-effective, real-time, non-invasive and safe imaging modality widely used in the clinic for anatomical and functional imaging. With the introduction of novel molecularly-targeted ultrasound contrast agents, another dimension of ultrasound has become a reality: diagnosing and monitoring pathological processes at the molecular level. Most commonly used ultrasound molecular imaging contrast agents are micron sized, gas-containing microbubbles functionalized to recognize and attach to molecules expressed on inflamed or angiogenic vascular endothelial cells. There are several potential clinical applications currently being explored including earlier detection, molecular profiling, and monitoring of cancer, as well as visualization of ischemic memory in transient myocardial ischemia, monitoring of disease activity in inflammatory bowel disease, and assessment of arteriosclerosis. Recently, a first clinical grade ultrasound contrast agent (BR55), targeted at a molecule expressed in neoangiogenesis (vascular endothelial growth factor receptor type 2; VEGFR2) has been introduced and safety and feasibility of VEGFR2-targeted ultrasound imaging is being explored in first inhuman clinical trials in various cancer types. This review describes the design of ultrasound molecular imaging contrast agents, imaging techniques, and potential future clinical applications of ultrasound molecular imaging.

  12. 3 Tesla proton MRI for the diagnosis of pneumonia/lung infiltrates in neutropenic patients with acute myeloid leukemia: Initial results in comparison to HRCT

    Energy Technology Data Exchange (ETDEWEB)

    Attenberger, U.I., E-mail: [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim (Germany); Morelli, J.N. [Scott and White Hospital, Texas A and M Health Sciences Center, Temple (United States); Henzler, T. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim (Germany); Buchheidt, D. [Department of Hematology and Oncology, University Medical Center Mannheim (Germany); Fink, C. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim (Germany); Department of Radiology, AKH Celle, Celle (Germany); Schoenberg, S.O.; Reichert, M. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim (Germany)


    Purpose: To evaluate the diagnostic accuracy of 3 Tesla proton MRI for the assessment of pneumonia/lung infiltrates in neutropenic patients with acute myeloid leukemia. Material and methods: In a prospective study, 3 Tesla MRI was performed in 19 febrile neutropenic patients (5 women, 14 men; mean age 61 years ± 14.2; range 23–77 years). All patients underwent high-resolution CT less than 24 h prior to MRI. The MRI protocol (Magnetom Tim Trio, Siemens) included a T2-weighted HASTE sequence (TE/TR: 49 ms/∞, slice thickness 6 mm) and a high-resolution 3D VIBE sequence with an ultra-short TE < 1 ms (TE/TR 0.8/2.9 ms, slice thickness 2 mm). The VIBE sequence was examined before and after intravenous injection of 0.1 mmol/kg gadoterate meglumine (Dotarem, Guerbet). The presence of pulmonary abnormalities, their location within the lung, and lesion type (nodules, consolidations, glass opacity areas) were analyzed by one reader and compared to the findings of HRCT, which was evaluated by a second independent radiologist who served as the reference standard. The findings were compared per lobe in each patient and rated as true positive (TP) findings if all three characteristics (presence, location, and lesion type) listed above were concordant to HRCT. Results: Pulmonary abnormalities were characterized by 3 Tesla MRI with a sensitivity of 82.3% and a specificity of 78.6%, resulting in an overall accuracy of 88% (NPV/PPV 66.7%/89.5%). In 51 lobes (19 of 19 patients), pulmonary abnormalities visualized by MR were judged to be concordant in their location and in the lesion type identified by both readers. In 22 lobes (11 of 19 patients), no abnormalities were present on either MR or HRCT (true negative). In 6 lobes (5 of 19 patients), ground glass opacity areas were detected on MRI but were not visible on HRCT (false positives). In 11 lobes (7 of 19 patients), MRI failed to detect ground glass opacity areas identified by HRCT. However, since the abnormalities were

  13. MR visualization of the inner ear structures: comparison of 1.5 Tesla and 3 Tesla images

    Energy Technology Data Exchange (ETDEWEB)

    Graf, H.; Schick, F. [Tuebingen Univ. (Germany). Sektion Experimentelle Radiologie; Claussen, C.D.; Seemann, M.D. [Tuebingen Univ. (Germany). Abt. fuer Radiologische Diagnostik


    Aim of the Study: To compare high resolution MRI examinations of inner ear structures at 1.5 T and at 3 T. Method: Temporal bones were measured bilaterally in 3 healthy volunteers in a 1.5 T and in a 3 T MR-scanner using the respective one channel head coil (quadrature detection) of the manufacturer. The same steady-state gradient echo sequence (3D-CISS) was employed at a voxel size of 0.4x0.4x0.4mm{sup 3}. The signal-to-noise ratio (SNR) was determined quantitatively. Results: An SNR of 8 could be achieved for the measurements at 3 T in 7:37 min. The SNR at 3 T was, on average, a factor of 1.34 higher than that at 1.5 T despite the fact that the excitation angle had to be drastically reduced ({alpha} = 42 instead of {alpha} = 70 at 1.5 T) due to the limit of the specific absorption rate (SAR). Discussion: The MR representation of the inner ear is clearly improved at 3 T. To obtain the same SNR at 1.5 T approximately the double measuring time would be required, connected with reduced patient comfort and an increased risk for a displacement of the head during the high resolution measurement. (orig.) [German] Ziel der Studie: Vergleich der hochaufloesenden MR-Bildgebung der Innenohrstrukturen bei 1,5 T und 3 T. Methode: Es wurden jeweils beide Felsenbeine von 3 freiwilligen, gehoergesunden Probanden an einem 1,5 T und einem 3 T MR-Tomographen mit einer einkanaligen Quadratur-Kopfspule des Herstellers gemessen. An beiden Tomographen wurde dieselbe Steady-State Gradientenecho-Sequenz (3D-CISS) bei einer Voxelgroesse von 0,4x0,4x0,4mm{sup 3} verwendet. Das erhaltene Signal-Rausch-Verhaeltnis (SNR) wurde quantitativ ermittelt. Ergebnis: Ein SNR von 8 wurde fuer die Messungen bei 3 T in 7:37 min erreicht. Der SNR-Wert bei 3 T uebertraf den Wert bei 1,5 T um durchschnittlich das 1,34-fache, obwohl aufgrund der Begrenzung in der spezifischen Absorptionsrate (SAR) nur mit deutlich reduziertem Anregewinkel ({alpha} = 42 anstatt {alpha} = 70 bei 1,5 T) gearbeitet werden konnte. Diskussion: Die Innenohrdarstellung mittels MRT wird bei 3 T deutlich verbessert. Bei 1,5 T waere fuer dasselbe SNR ungefaehr die doppelte Messzeit erforderlich, verbunden mit deutlich reduziertem Patientenkomfort und einem erhoehten Risiko fuer eine Verlagerung des Kopfes waehrend der hochaufgeloesten Messung. (orig.)

  14. Visual Impairment/lntracranial Pressure Risk Clinical Care Data Tools (United States)

    Van Baalen, Mary; Mason, Sara S.; Taiym, Wafa; Wear, Mary L.; Moynihan, Shannan; Alexander, David; Hart, Steve; Tarver, William


    Prior to 2010, several ISS crewmembers returned from spaceflight with changes to their vision, ranging from a mild hyperopic shift to frank disc edema. As a result, NASA expanded clinical vision testing to include more comprehensive medical imaging, including Optical Coherence Tomography and 3 Tesla Brain and Orbit MRIs. The Space and Clinical Operations (SCO) Division developed a clinical practice guideline that classified individuals based on their symptoms and diagnoses to facilitate clinical care. For the purposes of clinical surveillance, this classification was applied retrospectively to all crewmembers who had sufficient testing for classification. This classification is also a tool that has been leveraged for researchers to identify potential risk factors. In March 2014, driven in part by a more comprehensive understanding of the imaging data and increased imaging capability on orbit, the SCO Division revised their clinical care guidance to outline in-flight care and increase post-flight follow up. The new clinical guidance does not include a classification scheme

  15. Medical imaging in new drug clinical development. (United States)

    Wang, Yi-Xiang; Deng, Min


    Medical imaging can help answer key questions that arise during the drug development process. The role of medical imaging in new drug clinical trials includes identification of likely responders; detection and diagnosis of lesions and evaluation of their severity; and therapy monitoring and follow-up. Nuclear imaging techniques such as PET can be used to monitor drug pharmacokinetics and distribution and study specific molecular endpoints. In assessing drug efficacy, imaging biomarkers and imaging surrogate endpoints can be more objective and faster to measure than clinical outcomes, and allow small group sizes, quick results and good statistical power. Imaging also has important role in drug safety monitoring, particularly when there is no other suitable biomarkers available. Despite the long history of radiological sciences, its application to the drug development process is relatively recent. This review highlights the processes, opportunities, and challenges of medical imaging in new drug development.

  16. Ultrasound Molecular Imaging: Moving Towards Clinical Translation (United States)

    Abou-Elkacem, Lotfi; Bachawal, Sunitha V.; Willmann, Jürgen K.


    Ultrasound is a widely available, cost-effective, real-time, non-invasive and safe imaging modality widely used in the clinic for anatomical and functional imaging. With the introduction of novel molecularly-targeted ultrasound contrast agents, another dimension of ultrasound has become a reality: diagnosing and monitoring pathological processes at the molecular level. Most commonly used ultrasound molecular imaging contrast agents are micron sized, gas-containing microbubbles functionalized to recognize and attach to molecules expressed on inflamed or angiogenic vascular endothelial cells. There are several potential clinical applications currently being explored including earlier detection, molecular profiling, and monitoring of cancer, as well as visualization of ischemic memory in transient myocardial ischemia, monitoring of disease activity in inflammatory bowel disease, and assessment of arteriosclerosis. Recently, a first clinical grade ultrasound contrast agent (BR55), targeted at a molecule expressed in neoangiogenesis (vascular endothelial growth factor receptor type 2; VEGFR2) has been introduced and safety and feasibility of VEGFR2-targeted ultrasound imaging is being explored in first inhuman clinical trials in various cancer types. This review describes the design of ultrasound molecular imaging contrast agents, imaging techniques, and potential future clinical applications of ultrasound molecular imaging. PMID:25851932

  17. Ultrasound molecular imaging: Moving toward clinical translation. (United States)

    Abou-Elkacem, Lotfi; Bachawal, Sunitha V; Willmann, Jürgen K


    Ultrasound is a widely available, cost-effective, real-time, non-invasive and safe imaging modality widely used in the clinic for anatomical and functional imaging. With the introduction of novel molecularly-targeted ultrasound contrast agents, another dimension of ultrasound has become a reality: diagnosing and monitoring pathological processes at the molecular level. Most commonly used ultrasound molecular imaging contrast agents are micron sized, gas-containing microbubbles functionalized to recognize and attach to molecules expressed on inflamed or angiogenic vascular endothelial cells. There are several potential clinical applications currently being explored including earlier detection, molecular profiling, and monitoring of cancer, as well as visualization of ischemic memory in transient myocardial ischemia, monitoring of disease activity in inflammatory bowel disease, and assessment of arteriosclerosis. Recently, a first clinical grade ultrasound contrast agent (BR55), targeted at a molecule expressed in neoangiogenesis (vascular endothelial growth factor receptor type 2; VEGFR2) has been introduced and safety and feasibility of VEGFR2-targeted ultrasound imaging is being explored in first inhuman clinical trials in various cancer types. This review describes the design of ultrasound molecular imaging contrast agents, imaging techniques, and potential future clinical applications of ultrasound molecular imaging.

  18. Clinics in diagnostic imaging (175) (United States)

    Krishnan, Vijay; Lim, Tze Chwan; Ho, Francis Cho Hao; Peh, Wilfred CG


    A 54-year-old man presented with change in behaviour, nocturnal enuresis, abnormal limb movement and headache of one week’s duration. The diagnosis of butterfly glioma (glioblastoma multiforme) was made based on imaging characteristics and was further confirmed by biopsy findings. As the corpus callosum is usually resistant to infiltration by tumours, a mass that involves and crosses the corpus callosum is suggestive of an aggressive neoplasm. Other neoplastic and non-neoplastic conditions that may involve the corpus callosum and mimic a butterfly glioma, as well as associated imaging features, are discussed. PMID:28361164

  19. Quantitative Imaging in Cancer Clinical Trials. (United States)

    Yankeelov, Thomas E; Mankoff, David A; Schwartz, Lawrence H; Lieberman, Frank S; Buatti, John M; Mountz, James M; Erickson, Bradley J; Fennessy, Fiona M M; Huang, Wei; Kalpathy-Cramer, Jayashree; Wahl, Richard L; Linden, Hannah M; Kinahan, Paul E; Zhao, Binsheng; Hylton, Nola M; Gillies, Robert J; Clarke, Laurence; Nordstrom, Robert; Rubin, Daniel L


    As anticancer therapies designed to target specific molecular pathways have been developed, it has become critical to develop methods to assess the response induced by such agents. Although traditional, anatomic CT, and MRI examinations are useful in many settings, increasing evidence suggests that these methods cannot answer the fundamental biologic and physiologic questions essential for assessment and, eventually, prediction of treatment response in the clinical trial setting, especially in the critical period soon after treatment is initiated. To optimally apply advances in quantitative imaging methods to trials of targeted cancer therapy, new infrastructure improvements are needed that incorporate these emerging techniques into the settings where they are most likely to have impact. In this review, we first elucidate the needs for therapeutic response assessment in the era of molecularly targeted therapy and describe how quantitative imaging can most effectively provide scientifically and clinically relevant data. We then describe the tools and methods required to apply quantitative imaging and provide concrete examples of work making these advances practically available for routine application in clinical trials. We conclude by proposing strategies to surmount barriers to wider incorporation of these quantitative imaging methods into clinical trials and, eventually, clinical practice. Our goal is to encourage and guide the oncology community to deploy standardized quantitative imaging techniques in clinical trials to further personalize care for cancer patients and to provide a more efficient path for the development of improved targeted therapies.

  20. Robust diffusion imaging framework for clinical studies

    CERN Document Server

    Maximov, Ivan I; Neuner, Irene; Shah, N Jon


    Clinical diffusion imaging requires short acquisition times and good image quality to permit its use in various medical applications. In turn, these demands require the development of a robust and efficient post-processing framework in order to guarantee useful and reliable results. However, multiple artefacts abound in in vivo measurements; from either subject such as cardiac pulsation, bulk head motion, respiratory motion and involuntary tics and tremor, or imaging hardware related problems, such as table vibrations, etc. These artefacts can severely degrade the resulting images and render diffusion analysis difficult or impossible. In order to overcome these problems, we developed a robust and efficient framework enabling the use of initially corrupted images from a clinical study. At the heart of this framework is an improved least trimmed squares diffusion tensor estimation algorithm that works well with severely degraded datasets with low signal-to-noise ratio. This approach has been compared with other...

  1. Quantitative imaging for clinical dosimetry (United States)

    Bardiès, Manuel; Flux, Glenn; Lassmann, Michael; Monsieurs, Myriam; Savolainen, Sauli; Strand, Sven-Erik


    Patient-specific dosimetry in nuclear medicine is now a legal requirement in many countries throughout the EU for targeted radionuclide therapy (TRT) applications. In order to achieve that goal, an increased level of accuracy in dosimetry procedures is needed. Current research in nuclear medicine dosimetry should not only aim at developing new methods to assess the delivered radiation absorbed dose at the patient level, but also to ensure that the proposed methods can be put into practice in a sufficient number of institutions. A unified dosimetry methodology is required for making clinical outcome comparisons possible.

  2. Comprehensive small animal imaging strategies on a clinical 3 T dedicated head MR-scanner; adapted methods and sequence protocols in CNS pathologies.

    Directory of Open Access Journals (Sweden)

    Deepu R Pillai

    Full Text Available BACKGROUND: Small animal models of human diseases are an indispensable aspect of pre-clinical research. Being dynamic, most pathologies demand extensive longitudinal monitoring to understand disease mechanisms, drug efficacy and side effects. These considerations often demand the concomitant development of monitoring systems with sufficient temporal and spatial resolution. METHODOLOGY AND RESULTS: This study attempts to configure and optimize a clinical 3 Tesla magnetic resonance scanner to facilitate imaging of small animal central nervous system pathologies. The hardware of the scanner was complemented by a custom-built, 4-channel phased array coil system. Extensive modification of standard sequence protocols was carried out based on tissue relaxometric calculations. Proton density differences between the gray and white matter of the rodent spinal cord along with transverse relaxation due to magnetic susceptibility differences at the cortex and striatum of both rats and mice demonstrated statistically significant differences. The employed parallel imaging reconstruction algorithms had distinct properties dependent on the sequence type and in the presence of the contrast agent. The attempt to morphologically phenotype a normal healthy rat brain in multiple planes delineated a number of anatomical regions, and all the clinically relevant sequels following acute cerebral ischemia could be adequately characterized. Changes in blood-brain-barrier permeability following ischemia-reperfusion were also apparent at a later time. Typical characteristics of intra-cerebral haemorrhage at acute and chronic stages were also visualized up to one month. Two models of rodent spinal cord injury were adequately characterized and closely mimicked the results of histological studies. In the employed rodent animal handling system a mouse model of glioblastoma was also studied with unequivocal results. CONCLUSIONS: The implemented customizations including extensive

  3. Barrett's esophagus: clinical features, obesity, and imaging.

    LENUS (Irish Health Repository)

    Quigley, Eamonn M M


    The following includes commentaries on clinical features and imaging of Barrett\\'s esophagus (BE); the clinical factors that influence the development of BE; the influence of body fat distribution and central obesity; the role of adipocytokines and proinflammatory markers in carcinogenesis; the role of body mass index (BMI) in healing of Barrett\\'s epithelium; the role of surgery in prevention of carcinogenesis in BE; the importance of double-contrast esophagography and cross-sectional images of the esophagus; and the value of positron emission tomography\\/computed tomography.

  4. MR neurography of ulnar nerve entrapment at the cubital tunnel: a diffusion tensor imaging study

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    Breitenseher, Julia B.; Berzaczy, Dominik; Nemec, Stefan F.; Weber, Michael; Prayer, Daniela; Kasprian, Gregor [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Kranz, Gottfried; Sycha, Thomas [Medical University of Vienna, Department of Neurology, Vienna (Austria); Hold, Alina [Medical University of Vienna, Department of Plastic and Reconstructive Surgery, Vienna (Austria)


    MR neurography, diffusion tensor imaging (DTI) and tractography at 3 Tesla were evaluated for the assessment of patients with ulnar neuropathy at the elbow (UNE). Axial T2-weighted and single-shot DTI sequences (16 gradient encoding directions) were acquired, covering the cubital tunnel of 46 patients with clinically and electrodiagnostically confirmed UNE and 20 healthy controls. Cross-sectional area (CSA) was measured at the retrocondylar sulcus and FA and ADC values on each section along the ulnar nerve. Three-dimensional nerve tractography and T2-weighted neurography results were independently assessed by two raters. Patients showed a significant reduction of ulnar nerve FA values at the retrocondylar sulcus (p = 0.002) and the deep flexor fascia (p = 0.005). At tractography, a complete or partial discontinuity of the ulnar nerve was found in 26/40 (65 %) of patients. Assessment of T2 neurography was most sensitive in detecting UNE (sensitivity, 91 %; specificity, 79 %), followed by tractography (88 %/69 %). CSA and FA measurements were less effective in detecting UNE. T2-weighted neurography remains the most sensitive MR technique in the imaging evaluation of clinically manifest UNE. DTI-based neurography at 3 Tesla supports the MR imaging assessment of UNE patients by adding quantitative and 3D imaging data. (orig.)

  5. Clinically Relevant Imaging in Tuberous Sclerosis

    Directory of Open Access Journals (Sweden)

    Rupa Radhakrishnan


    Full Text Available Tuberous sclerosis (TS, also known as Bourneville disease or Bourneville-Pringle disease, is an autosomal dominant genetic disorder classically characterized by the presence of hamartomatous growths in multiple organs. TS and tuberous sclerosis complex (TSC are different terms for the same genetic condition. Both terms describe clinical changes due to mutations involving either of the two genes named TSC1 and TSC2, which regulate cell growth. The diagnosis of TSC is established using diagnostic criteria based on clinical and imaging findings. Routine screening and surveillance of patients with TSC is needed to determine the presence and extent of organ involvement, especially the brain, kidneys, and lungs, and identify the development of associated complications. As the treatment is organ specific, imaging plays a crucial role in the management of patients with TSC.

  6. Intracranial Infections: Clinical and Imaging Characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Foerster, B.R.; Thurnher, M.M.; Malani, P.N.; Petrou, M.; Carets-Zumelzu, F.; Sundgren, P.C. [Dept. of Radiology, and Divisions of Infectious Diseases and G eriatric Medicine, Dept. of Internal Medicine, Univ. of Michigan Medical Center, Ann Arbor, MI (United States)


    The radiologist plays a crucial role in identifying and narrowing the differential diagnosis of intracranial infections. A thorough understanding of the intracranial compartment anatomy and characteristic imaging findings of specific pathogens, as well incorporation of the clinical information, is essential to establish correct diagnosis. Specific types of infections have certain propensities for different anatomical regions within the brain. In addition, the imaging findings must be placed in the context of the clinical setting, particularly in immunocompromised and human immunodeficiency virus (HIV)-positive patients. This paper describes and depicts infections within the different compartments of the brain. Pathology-proven infectious cases are presented in both immunocompetent and immunocompromised patients, with a discussion of the characteristic findings of each pathogen. Magnetic resonance spectroscopy (MRS) characteristics for several infections are also discussed.

  7. Hereditary angioedema: imaging manifestations and clinical management. (United States)

    Gakhal, Mandip S; Marcotte, Gregory V


    Hereditary angioedema is a genetic disorder typically related to insufficient or dysfunctional C1-esterase inhibitor. Patients present with episodic swelling of various body parts, such as the face, neck, bowel, genitals, and extremities. Acute or severe symptoms can lead to patients presenting to the emergency room, particularly when the neck and abdominopelvic regions are affected, which is often accompanied by radiologic imaging evaluation. Patients with hereditary angioedema can pose a diagnostic challenge for emergency department physicians and radiologists at initial presentation, and the correct diagnosis may be missed or delayed, due to lack of clinical awareness of the disease or lack of its consideration in the radiologic differential diagnosis. Timely diagnosis of hereditary angioedema and rapid initiation of appropriate therapy can avoid potentially life-threatening complications. This article focuses on the spectrum of common and characteristic acute imaging manifestations of hereditary angioedema and provides an update on important recent developments in its clinical management and treatment.

  8. Clinical and imaging features of fludarabine neurotoxicity. (United States)

    Lee, Michael S; McKinney, Alexander M; Brace, Jeffrey R; Santacruz, Karen


    Neurotoxicity from intravenous fludarabine is a rare but recognized clinical entity. Its brain imaging features have not been extensively described. Three patients received 38.5 mg or 40 mg/m per day fludarabine in a 5-day intravenous infusion before bone marrow transplantation in treatment of hematopoietic malignancies. Several weeks later, each patient developed progressive neurologic decline, including retrogeniculate blindness, leading to coma and death. Brain MRI showed progressively enlarging but mild T2/FLAIR hyperintensities in the periventricular white matter. The lesions demonstrated restricted diffusion but did not enhance. Because the neurotoxicity of fludarabine appears long after exposure, neurologic decline in this setting is likely to be attributed to opportunistic disease. However, the imaging features are distinctive in their latency and in being mild relative to the profound clinical features. The safe dose of fludarabine in this context remains controversial.

  9. Clinical applications of cardiovascular magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Marcu, C.B.; Beek, A.M.; Van Rossum, A.C. [Hospital of Saint Raphael, Cardiac Diagnostic Unit, New Haven, CT (United States)], E-mail:


    Cardiovascular magnetic resonance imaging (MRI) has evolved from an effective research tool into a clinically proven, safe and comprehensive imaging modality. It provides anatomic and functional information in acquired and congenital heart disease and is the most precise technique for quantification of ventricular volumes, function and mass. Owing to its excellent interstudy reproducibility, cardiovascular MRI is the optimal method for assessment of changes in ventricular parameters after therapeutic intervention. Delayed contrast enhancement is an accurate and robust method used in the diagnosis of ischemic and nonischemic cardiomyopathies and less common diseases, such as cardiac sarcoidosis and myocarditis. First-pass magnetic contrast myocardial perfusion is becoming an alternative to radionuclide techniques for the detection of coronary atherosclerotic disease. In this review we outline the techniques used in cardiovascular MRI and discuss the most common clinical applications. (author)

  10. Metanephric Adenoma: clinical, imaging, and histological findings

    Energy Technology Data Exchange (ETDEWEB)

    Torricelli, Fabio Cesar Miranda; Marchini, Giovanni Scala, E-mail: [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Dept. de Urologica; Campos, Rodrigo Sousa Madeira [Hospital do Servidor Publico Estadual, Sao Paulo, SP (Brazil). Dept. de Urologia; Gil, Antonio Otero [Instituto Dante Pazanezzi, Sao Paulo, SP (Brazil)


    Metanephric adenoma (MA), also designated nephrogenic nephroma or renal epithelial tumor resembling immature nephron, has just been recently recognized as a special type of benign renal epithelial tumor. Only few reports are found in the literature regarding this rare renal tumor. The purpose of this paper is to describe our clinical, imaging and histological / immunohistochemical observations of MA diagnosed in two patients and compare these data to previous information reported in medical databases (author)

  11. Clinical application of several tumor imaging agents

    Institute of Scientific and Technical Information of China (English)


    Neoplasms is one of the main diseases for harming health.It is difficult to prevent the neoplasms because the factors of bringing out them are complex.To raise survival rate the early diagnosis of tumors is very important.Radionuclide imaging is useful to detect recurrent or residual diseaseand to identificate benign or malignant tumor.Several tumorimaging agents as following have clinical significance indiagnosing tumors.

  12. A 4-channel 3 Tesla phased array receive coil for awake rhesus monkey fMRI and diffusion MRI experiments


    Khachaturian, Mark Haig


    Awake monkey fMRI and diffusion MRI combined with conventional neuroscience techniques has the potential to study the structural and functional neural network. The majority of monkey fMRI and diffusion MRI experiments are performed with single coils which suffer from severe EPI distortions which limit resolution. By constructing phased array coils for monkey MRI studies, gains in SNR and anatomical accuracy (i.e., reduction of EPI distortions) can be achieved using parallel imaging. The major...

  13. A 4-channel 3 Tesla phased array receive coil for awake rhesus monkey fMRI and diffusion MRI experiments. (United States)

    Khachaturian, Mark Haig


    Awake monkey fMRI and diffusion MRI combined with conventional neuroscience techniques has the potential to study the structural and functional neural network. The majority of monkey fMRI and diffusion MRI experiments are performed with single coils which suffer from severe EPI distortions which limit resolution. By constructing phased array coils for monkey MRI studies, gains in SNR and anatomical accuracy (i.e., reduction of EPI distortions) can be achieved using parallel imaging. The major challenges associated with constructing phased array coils for monkeys are the variation in head size and space constraints. Here, we apply phased array technology to a 4-channel phased array coil capable of improving the resolution and image quality of full brain awake monkey fMRI and diffusion MRI experiments. The phased array coil is that can adapt to different rhesus monkey head sizes (ages 4-8) and fits in the limited space provided by monkey stereotactic equipment and provides SNR gains in primary visual cortex and anatomical accuracy in conjunction with parallel imaging and improves resolution in fMRI experiments by a factor of 2 (1.25 mm to 1.0 mm isotropic) and diffusion MRI experiments by a factor of 4 (1.5 mm to 0.9 mm isotropic).

  14. Monitoring of gadolinium-BOPTA uptake into the vessel wall during magnetic resonance (MR)-guided angioplasty of the peripheral arteries with a paclitaxel/gadolinium-BOPTA-coated balloon. An experimental study at 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Neizel, M.; Kelm, M. [University Hospital Duesseldorf (Germany). Dept. of Cardiology, Pneumology and Angiology; Ruebben, A.; Weiss, N. [Aachen Resonance, Aachen (Germany); Guenther, R.W. [University Hospital Aachen (Germany). Dept. of Radiology; Krombach, G.A. [University Hospital Giessen (Germany). Dept. of Radiology


    Purpose: The success of paclitaxel distribution within the vessel wall during paclitaxel-coated balloon angioplasty to prevent restenosis cannot be monitored under X-ray guidance. The aim of this pilot study was to demonstrate the feasibility of monitoring Gadolinium-BOPTA delivery within the vessel wall during magnetic resonance (MR)-guided paclitaxel/Gadolinium-BOPTA-coated balloon angioplasty of the peripheral arteries. Materials and methods: 6 pigs (47 ± 2 kg) were investigated. All experiments were performed using a 3 Tesla MR scanner. MR-guided bilaterial angioplasty of the iliac arteries was performed using a paclitaxel/MR contrast agent-coated balloon catheter. The feasibility of monitoring the delivery of Gadolinium-BOPTA to the vessel was assessed in 4 animals. In two additional animals, bilateral stenosis was surgically induced in the iliac arteries. Delivery of paclitaxel to the vessel wall was monitored using a 3 D T1-weighted gradient echo (GE) sequence for delineation of the vessel wall. Normalized signal intensity (SI) of the vessel wall was measured before and repeatedly after the intervention for 45 min. in all animals. Results: Paclitaxel/gadolinium-BOPTA-coated balloon angioplasty was successfully accomplished in all iliac arteries (n = 12). In animals with stenosis MR-angiography demonstrated successful dilatation (n = 4). The normalized SI of the vessel wall on T1-weighted GE images significantly increased after the intervention in all animals with and without stenosis for more than 45 min. (p < 0.001). Conclusion: Monitoring of Gadolinium-BOPTA into the vessel wall during MR-guided coated balloon angioplasty is feasible. This is a first step towards providing a tool for the online control of homogenous drug delivery after paclitaxel-coated balloon angioplasty. (orig.)

  15. Hepatic Iron Quantification on 3 Tesla (3 T Magnetic Resonance (MR: Technical Challenges and Solutions

    Directory of Open Access Journals (Sweden)

    Muhammad Anwar


    Full Text Available MR has become a reliable and noninvasive method of hepatic iron quantification. Currently, most of the hepatic iron quantification is performed on 1.5 T MR, and the biopsy measurements have been paired with R2 and R2* values for 1.5 T MR. As the use of 3 T MR scanners is steadily increasing in clinical practice, it has become important to evaluate the practicality of calculating iron burden at 3 T MR. Hepatic iron quantification on 3 T MR requires a better understanding of the process and more stringent technical considerations. The purpose of this work is to focus on the technical challenges in establishing a relationship between T2* values at 1.5 T MR and 3 T MR for hepatic iron concentration (HIC and to develop an appropriately optimized MR protocol for the evaluation of T2* values in the liver at 3 T magnetic field strength. We studied 22 sickle cell patients using multiecho fast gradient-echo sequence (MFGRE 3 T MR and compared the results with serum ferritin and liver biopsy results. Our study showed that the quantification of hepatic iron on 3 T MRI in sickle cell disease patients correlates well with clinical blood test results and biopsy results. 3 T MR liver iron quantification based on MFGRE can be used for hepatic iron quantification in transfused patients.

  16. Assessing liver function by liver enhancement during the hepatobiliary phase with Gd-EOB-DTPA-enhanced MRI at 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Verloh, N.; Haimerl, M.; Schlabeck, M.; Schreyer, A.G.; Stroszczynski, C.; Fellner, C.; Wiggermann, P. [University Hospital Regensburg, Department of Radiology, Regensburg (Germany); Zeman, F. [University Hospital Regensburg, Center for Clinical Trials, Regensburg (Germany); Barreiros, A. [University Hospital Regensburg, Department of Gastroenterology, Regensburg (Germany); Loss, M. [University Hospital Regensburg, Department of Surgery, Regensburg (Germany)


    The purpose of this study was to evaluate the usefulness of Gd-EOB-DTPA-enhanced 3-T MRI to determine the hepatic functional reserve expressed by the model for end-stage liver disease (MELD) score. A total of 121 patients with normal liver function (NLF; MELD score ≤ 10) and 29 patients with impaired liver function (ILF; MELD score > 10) underwent contrast-enhanced MRI with a hepatocyte-specific contrast agent at 3T. T1-weighted volume interpolated breath-hold examination (VIBE) sequences with fat suppression were acquired before and 20 min after contrast injection. Relative enhancement (RE) between plain signal intensity and contrast-enhanced signal intensity was calculated and was used to determine Gd-EOB-DTPA uptake into the liver parenchyma for patients with different MELD scores. RE differed significantly (p ≤ 0.001) between patients with NLF (87.2 ± 29.5 %) and patients with ILF (45.4 ± 26.5 %). The optimal cut-off value for RE to differentiate NLF from ILF was 47.7 % (AUC 0.87). This cut-off value showed a sensitivity of 82.8 % and a specificity of 92.7 % for the differentiation of the analysed groups. Gd-EOB-DTPA uptake in hepatocytes is strongly affected by liver function. Gd-EOB-DTPA-enhanced MRI and assessment of RE during the hepatobiliary phase (HBP) may serve as a useful image-based test in liver imaging for determining regional and global liver function. (orig.)

  17. Measurement of the weighted peak level for occupational exposure to gradient magnetic fields for 1.5 and 3 Tesla MRI body scanners. (United States)

    Bonutti, F; Tecchio, M; Maieron, M; Trevisan, D; Negro, C; Calligaris, F


    The purpose of this work is to give a contribution to the construction of a comprehensive knowledge of the exposure levels to gradient magnetic fields (GMF) in terms of the weighed peak (WP), especially for 3 Tesla scanners for which there are still few works available in the literature. A new generation probe for the measurement of electromagnetic fields in the range of 1 Hz-400 kHz was used to assess the occupational exposure levels to the GMF for 1.5 and 3.0 Tesla MRI body scanners, using the method of the WP according to the International Commission on Non-Ionizing Radiation Protection (ICNIRP) approach. The probe was placed at a height of 1.1 m, close to the MRI scanners, where operators could stay during some medical procedures with particular issues. The measurements were performed for a set of typical acquisition sequences for body (liver) and head exams. The measured values of WP were in compliance with ICNIRP 2010 reference levels for occupational exposures.

  18. Accuracy of 3 Tesla pelvic phased-array multiparametric MRI in diagnosing prostate cancer at repeat biopsy

    Directory of Open Access Journals (Sweden)

    Pietro Pepe


    Full Text Available Introduction. Multiparametric pelvic magnetic resonance imaging (mpMRI accuracy in prostate cancer (PCa diagnosis was evaluated. Materials and Methods. From June 2011 to December 2013, 168 patients (median 65 years with negative digital rectal examination underwent repeat transperineal saturation biopsy (SPBx; median 28 cores for persistently high or increasing PSA values, PSA >10 ng/ml or PSA values between 4.1-10 o r 2.6-4 ng/ml with free/total PSA < 25% and < 20%, respectively. All patients underwent mpMRI using a 3.0 Tesla scanner equipped with surface 16 channels phased-array coil and lesions suspicious for PCa were submitted to additional targeted biopsies. Results. A T1c PCa was found in 66 (39% cases; SPBx and mpMRI-suspicious targeted biopsy diagnosed 60 (91% and 52 (78.8% cancers missing 6 (all of the anterior zone and 14 cancers (12 and 2 of the lateral margins and anterior zone, respectively; in detail, mpMRI missed 12 (18.1% PCa charaterized by microfocal (1 positive core with greatest percentage of cancer and Gleason score equal to 5% and 6, respectively disease at risk for insignificant cancer. The diameter of the suspicious mpMRI lesion was directly correlated to the diagnosis of PCa with poor Gleason score (p < 0.05; detection rate of cancer for each suspicious mpMRI core was 35.3%. Diagnostic accuracy, sensitivity, specificity, positive and negative predictive value of mpMRI in diagnosing PCa was 75.7%, 82.5%, 71.8%, 78.9%, 87.9%, respectively. Conclusion. Multiparametric pMRI improved SPBx accuracy in diagnosing significant anterior PCa; the diameter of mpMRI suspicious lesion resulted significantly predictive of aggressive cancers.

  19. High-resolution cine MRI with TGRAPPA for fast assessment of left ventricular function at 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Theisen, Daniel, E-mail: [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Munich Heart Alliance, Munich (Germany); Sandner, Torleif A., E-mail: [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Bamberg, Fabian, E-mail: [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Munich Heart Alliance, Munich (Germany); Bauner, Kerstin U., E-mail: [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Schwab, Felix, E-mail: [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Schwarz, Florian, E-mail: [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Arnoldi, Elisabeth, E-mail: [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Reiser, Maximilian F., E-mail: [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Munich Heart Alliance, Munich (Germany); Wintersperger, Bernd J., E-mail: [Department of Clinical Radiology, University Hospitals of Munich Grosshadern, Munich (Germany); Department of Medical Imaging, University of Toronto, Toronto, Ontario (Canada)


    Purpose: To implement and evaluate the accuracy of multislice dual-breath hold cine MR for analysis of global systolic and diastolic left ventricular function at 3 T. Materials and methods: 25 patients referred to cardiac MR underwent cine imaging at 3 T (MAGNETOM Verio) using prospective triggered SSFP (TR 3.1 ms; TE 1.4 ms; FA 60°). Analysis of LV function was performed using a standard non-accelerated single-slice approach (STD) with multiple breath-holds and an accelerated multi-slice technique (TGRAPPA; R = 4) encompassing the ventricles with 5 slices/breath-hold. Parameters of spatial and temporal resolution were kept identical (pixel: 1.9 × 2.5 mm{sup 2}; temporal resolution: 47 ms). Data of both acquisition techniques were analyzed by two readers using semiautomatic algorithms (syngoARGUS) with respect to EDV, ESV, EF, myocardial mass (MM), peak filling rate (PFR) and peak ejection rate (PER) including assessment of interobserver agreement. Results: Volumetric results of the TGRAPPA approach did not show significant differences to the STD approach for left ventricular ejection fraction (62.3 ± 10.6 vs. 61.0 ± 8.4, P = 0.2), end-diastolic volume (135.8 ± 47.5 vs. 130.8 ± 46.4, P = 0.07), endsystolic volume (53.0 ± 29.7 vs. 53.1 ± 32.7, P = 0.99) and myocardial mass (114.2 ± 32.5 vs. 114.6 ± 30.6, P = 0.9). Moreover, a comparison of peak ejection rate (601.3 ± 190.2 vs. 590.8 ± 218.2, P = 0.8) and peak filling rate (535.1 ± 191.2 vs. 535.4 ± 210.7, P = 0.99) did not reveal significant differences between the two groups. Limits in interobserver agreement were low for all systolic and diastolic parameters in both groups (P ≥ 0.05). Total acquisition time for STD was 273 ± 124 s and 34 ± 5 s for TGRAPPA (P ≤ 0.001). Evaluation time for standard and multislice approach was equal (10.8 ± 1.4 vs. 9.8 ± 2.1 min; P = 0.08)

  20. Functional imaging in head and neck squamous cell carcinoma: correlation of PET/CT and diffusion-weighted imaging at 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Fruehwald-Pallamar, Julia; Czerny, Christian; Mayerhoefer, Marius E.; Weber, Michael; Fruehwald, Laura; Herneth, Andreas M. [Medical University of Vienna, Department of Radiology, Vienna (Austria); Halpern, Benjamin S. [Medical University of Vienna, Department of Radiology, Vienna (Austria); Harvard Medical School, Department of Nuclear Medicine, Brigham and Women' s Hospital, Boston, MA (United States); Eder-Czembirek, Christina [Medical University of Vienna, University Hospital for Cranio, Maxillofacial and Oral Surgery, Vienna (Austria); Brunner, Markus [Medical University of Vienna, Department of Otorhinolaryngology, Head and Neck Surgery, Vienna (Austria); Schuetz, Matthias [Medical University of Vienna, Department of Nuclear Medicine, Vienna (Austria)


    The purposes of this study were: (a) to prospectively assess the correlation between apparent diffusion coefficient (ADC) values and maximum standardized uptake values (SUVmax) in patients with head and neck squamous cell carcinomas (SCC); and (b) to assess ADC and SUVmax values in relation to different tumour grades and stages in our patient population. The study group comprised 31 consecutive patients with biopsy-proven head and neck squamous cell carcinoma who were examined using a 3T MRI scanner with a 16-channel head and neck coil. In addition to routine sequences, axial (DWIBS) and sagittal (DW-EPI) diffusion-weighted sequences were obtained using b-values of 0 mm{sup 2}/s and 800 mm{sup 2}/s. The ADC maps were calculated automatically. The ADC values of the tumours were measured with three regions of interest (ROIs) of standard size, and an ROI covering the entire tumour. In all patients, contrast-enhanced, whole-body {sup 18}F-FDG PET/CT was performed within 2 weeks of the MRI examination. SUVmax was measured for every tumour using a 3-D freehand ROI that covered the entire tumour. Two-way repeated measures ANOVA was used for group comparisons. The Spearman rank correlation test was performed for ADC values. Mean ADC values in the 31 SCC were 0.902 ({+-}0.134) with a ROI of standard size, and 0.928 ({+-}0.160) with the large ROI measurements on the axial DWIBS sequence. The ADC values of the tumours were significantly higher when measured with the sagittal DW-EPI sequence: 1.051 ({+-}0.211) and 1.082 ({+-}0.208). We observed no significant differences in ADC values and SUVmax between the various T stages or histological grades of the tumours. SUVmax values (26.5{+-}12) did not correlate with ADC values on DWIBS or EPI. There is no correlation between the FDG uptake and the ADC value in head and neck SCC. The three different tumour grades and four tumour stages present in our study population could not be differentiated based on ADC values or SUV. (orig.)

  1. Clinical micro-CT for dental imaging (United States)

    Youn, Hanbean; Cho, Min Kook; Shon, Cheol-Soon; Cho, Bong Hae; Kim, Chang Hyuk; Kim, Ho Kyung


    We exploit the development of a clinical computed microtomography (micro-CT) system for dental imaging. While the conventional dental CT simply serves implant treatment, the clinical dental micro-CT may provide clinicians with a histologic evaluation. To investigate the feasibility of the realization of a dental micro-CT, we have constructed an experimental test system which mainly consists of a microfocus x-ray source, a rotational subject holder, and a flat-panel detector. The flat-panel detector is based on a matrix-addressed photodiode array coupled to a CsI:Tl scintillator. The detective quantum efficiency (DQE) of the detector was measured as a function of magnification based on the measured modulation-transfer function (MTF) and noise-power spectrum (NPS). The best MTF and DQE performances were achieved at the magnification factor of 3. Similar tendency of the spatial resolving power in tomography was also observed with a wire phantom having a 25 μm diameter. From the investigation of tomographs reconstructed from a humanoid skull phantom, the application of magnification in the system largely reduced both signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for a fixed dose at the entrance surface of the detector, 1.2 mGy, while this setup increased the dose at the object plane from 4.7 mGy to 19.1 mGy for the magnification factor from 2 to 4, respectively. Although the quantum mottles at the high magnification factor tackled the practical use in the clinic, the information contained in the magnified CT images was quite promising.

  2. A comparison between magnetic resonance angiography at 3 teslas (time-of-flight and contrast-enhanced and flat-panel digital subtraction angiography in the assessment of embolized brain aneurysms

    Directory of Open Access Journals (Sweden)

    Guilherme S. Nakiri


    Full Text Available PURPOSE: To compare the time-of-flight and contrast-enhanced- magnetic resonance angiography techniques in a 3 Tesla magnetic resonance unit with digital subtraction angiography with the latest flat-panel technology and 3D reconstruction in the evaluation of embolized cerebral aneurysms. INTRODUCTION: Many embolized aneurysms are subject to a recurrence of intra-aneurismal filling. Traditionally, imaging surveillance of coiled aneurysms has consisted of repeated digital subtraction angiography. However, this method has a small but significant risk of neurological complications, and many authors have advocated the use of noninvasive imaging methods for the surveillance of embolized aneurysms. METHODS: Forty-three aneurysms in 30 patients were studied consecutively between November 2009 and May 2010. Two interventional neuroradiologists rated the time-of-flight-magnetic resonance angiography, the contrast-enhanced-magnetic resonance angiography, and finally the digital subtraction angiography, first independently and then in consensus. The status of aneurysm occlusion was assessed according to the Raymond scale, which indicates the level of recanalization according to degrees: Class 1: excluded aneurysm; Class 2: persistence of a residual neck; Class 3: persistence of a residual aneurysm. The agreement among the analyses was assessed by applying the Kappa statistic. RESULTS: Inter-observer agreement was excellent for both methods (K = 0.93; 95 % CI: 0.84-1. Inter-technical agreement was almost perfect between time-of-flight-magnetic resonance angiography and digital subtraction angiography (K = 0.98; 95 % CI: 0.93-1 and between time-of-flight-magnetic resonance angiography and contrast-enhanced-magnetic resonance angiography (K = 0.98; 95% CI: 0.93-1. Disagreement occurred in only one case (2.3%, which was classified as Class I by time-of-flight-magnetic resonance angiography and Class II by digital subtraction angiography. The agreement between

  3. Perinatal clinical and imaging features of CLOVES syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez-Pineda, Israel [Virgen del Rocio Children' s Hospital, Department of Pediatric Surgery, Seville (Spain); Fajardo, Manuel [Virgen del Rocio Children' s Hospital, Department of Pediatric Radiology, Seville (Spain); Chaudry, Gulraiz; Alomari, Ahmad I. [Children' s Hospital Boston and Harvard Medical School, Division of Vascular and Interventional Radiology, Boston, MA (United States)


    We report a neonate with antenatal imaging features suggestive of CLOVES syndrome. Postnatal clinical and imaging findings confirmed the diagnosis, with the constellation of truncal overgrowth, cutaneous capillary malformation, lymphatic and musculoskeletal anomalies. The clinical, radiological and histopathological findings noted in this particular phenotype help differentiate it from other overgrowth syndromes with complex vascular anomalies. (orig.)

  4. Photoacoustic Imaging in Oncology: Translational Preclinical and Early Clinical Experience. (United States)

    Valluru, Keerthi S; Wilson, Katheryne E; Willmann, Jürgen K


    Photoacoustic imaging has evolved into a clinically translatable platform with the potential to complement existing imaging techniques for the management of cancer, including detection, characterization, prognosis, and treatment monitoring. In photoacoustic imaging, tissue is optically excited to produce ultrasonographic images that represent a spatial map of optical absorption of endogenous constituents such as hemoglobin, fat, melanin, and water or exogenous contrast agents such as dyes and nanoparticles. It can therefore provide functional and molecular information that allows noninvasive soft-tissue characterization. Photoacoustic imaging has matured over the years and is currently being translated into the clinic with various clinical studies underway. In this review, the current state of photoacoustic imaging is presented, including techniques and instrumentation, followed by a discussion of potential clinical applications of this technique for the detection and management of cancer. (©) RSNA, 2016.

  5. Non-Invasive Evaluation of the GABAergic/Glutamatergic System in Autistic Patients Observed by MEGA-Editing Proton MR Spectroscopy Using a Clinical 3 Tesla Instrument (United States)

    Harada, Masafumi; Taki, Masako M.; Nose, Ayumi; Kubo, Hitoshi; Mori, Kenji; Nishitani, Hiromu; Matsuda, Tsuyoshi


    Amino acids related to neurotransmitters and the GABAergic/glutamatergic system were measured using a 3 T-MRI instrument in 12 patients with autism and 10 normal controls. All measurements were performed in the frontal lobe (FL) and lenticular nuclei (LN) using a conventional sequence for n-acetyl aspartate (NAA) and glutamate (Glu), and the…

  6. Brain imaging with synthetic MR in children: clinical quality assessment

    Energy Technology Data Exchange (ETDEWEB)

    Betts, Aaron M.; Serai, Suraj [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Leach, James L.; Jones, Blaise V. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); University of Cincinnati College of Medicine, Cincinnati, OH (United States); Zhang, Bin [Cincinnati Children' s Hospital Medical Center, Biostatistics and Epidemiology, Cincinnati, OH (United States)


    Synthetic magnetic resonance imaging is a quantitative imaging technique that measures inherent T1-relaxation, T2-relaxation, and proton density. These inherent tissue properties allow synthesis of various imaging sequences from a single acquisition. Clinical use of synthetic MR imaging has been described in adult populations. However, use of synthetic MR imaging has not been previously reported in children. The purpose of this study is to report our assessment of diagnostic image quality using synthetic MR imaging in children. Synthetic MR acquisition was obtained in a sample of children undergoing brain MR imaging. Image quality assessments were performed on conventional and synthetic T1-weighted, T2-weighted, and FLAIR images. Standardized linear measurements were performed on conventional and synthetic T2 images. Estimates of patient age based upon myelination patterns were also performed. Conventional and synthetic MR images were evaluated on 30 children. Using a 4-point assessment scale, conventional imaging performed better than synthetic imaging for T1-weighted, T2-weighted, and FLAIR images. When the assessment was simplified to a dichotomized scale, the conventional and synthetic T1-weighted and T2-weighted images performed similarly. However, the superiority of conventional FLAIR images persisted in the dichotomized assessment. There were no statistically significant differences between linear measurements made on T2-weighted images. Estimates of patient age based upon pattern of myelination were also similar between conventional and synthetic techniques. Synthetic MR imaging may be acceptable for clinical use in children. However, users should be aware of current limitations that could impact clinical utility in the software version used in this study. (orig.)

  7. Clinical applications of choroidal imaging technologies

    Directory of Open Access Journals (Sweden)

    Jay Chhablani


    Full Text Available Choroid supplies the major blood supply to the eye, especially the outer retinal structures. Its understanding has significantly improved with the advent of advanced imaging modalities such as enhanced depth imaging technique and the newer swept source optical coherence tomography. Recent literature reports the findings of choroidal changes, quantitative as well as qualitative, in various chorioretinal disorders. This review article describes applications of choroidal imaging in the management of common diseases such as age-related macular degeneration, high myopia, central serous chorioretinopathy, chorioretinal inflammatory diseases, and tumors. This article briefly discusses future directions in choroidal imaging including angiography.

  8. Programmable Real-time Clinical Photoacoustic and Ultrasound Imaging System. (United States)

    Kim, Jeesu; Park, Sara; Jung, Yuhan; Chang, Sunyeob; Park, Jinyong; Zhang, Yumiao; Lovell, Jonathan F; Kim, Chulhong


    Photoacoustic imaging has attracted interest for its capacity to capture functional spectral information with high spatial and temporal resolution in biological tissues. Several photoacoustic imaging systems have been commercialized recently, but they are variously limited by non-clinically relevant designs, immobility, single anatomical utility (e.g., breast only), or non-programmable interfaces. Here, we present a real-time clinical photoacoustic and ultrasound imaging system which consists of an FDA-approved clinical ultrasound system integrated with a portable laser. The system is completely programmable, has an intuitive user interface, and can be adapted for different applications by switching handheld imaging probes with various transducer types. The customizable photoacoustic and ultrasound imaging system is intended to meet the diverse needs of medical researchers performing both clinical and preclinical photoacoustic studies.

  9. Vertigo Imaging; Clinical Radiology'

    Directory of Open Access Journals (Sweden)

    Jalal Jalal Shokouhi


    ;' and anxiety in psychiatry. "n- Clinical differentiating of peripheral and central vestibular lesion should be done by separating harmonic and disharmonic vestibular syndrome. "n- Examination of the patient with vertigo '' laboratory and imaging'' "n•Electronystagmography "n•Video-oculography "n•Audiometry "n•BAEP "n•CT "n•MRI "n - Common cause of vertigo '' all by image '' "nPeripheral: Physiological '' motion sickness'', benign paroxysmal positional vertigo , vestibular neuronitis , labyrinthitis , meniere disease , perilymph fistula. "nCentral: Brain stem TIA/infarct , post. fossa tumors , M.sclerosis, syringobulbia ,Arnold -chiari , temporal lobe epilepsy and basilar migraine. "nOthers: Cardiac , GI , psycogenic , mediacations , anemia and  hypotension , toxin and drugs: "n''aminoglycoside antibiotics,anticonvulsants,salycilates , alcohol , sedatives , antihistamins , antidepressants '' , cervical spondylosis , sensory deprivation ''neuropathy , visual impairment '',anemia , hypoglycemia , orthostatic hypotension and hyperventilation.  

  10. Differentiation of true anophthalmia from clinical anophthalmia using neuroradiological imaging

    Institute of Scientific and Technical Information of China (English)

    Ali; Riza; Cenk; Celebi; Hadi; Sasani


    Anophthalmia is a condition of the absence of an eye and the presence of a small eye within the orbit.It is associated with many known syndromes.Clinical findings,as well as imaging modalities and genetic analysis,are important in making the diagnosis.Imaging modalities are crucial scanning methods.Cryptophthalmos,cyclopia,synophthalmia and congenital cystic eye should be considered in differential diagnoses.We report two clinical anophthalmic siblings,emphasizing the importance of neuroradiological and orbital imaging findings in distinguishing true congenital anophthalmia from clinical anophthalmia.

  11. Clinical role of indium-111 antimyosin imaging

    Energy Technology Data Exchange (ETDEWEB)

    Bhattacharya, S.; Lahiri, A. (Northwich Park Hospital and Clinical Research Centre, Harrow (UK). Dept. of Cardiology Northwich Park Hospital and Clinical Research Centre, Harrow (UK). Div. of Cardiovascular Sciences)


    Myocyte necrosis occurs in ischaemic, inflammatory and toxic heart diseases and can be detected by indium 111 antimyosin imaging. This allows a non-invasive evaluation of the site, extent and quantitation of the severity of myocardial necrosis. Simultaneous imaging of perfusion in patients with myocardial infarction allows the differentiation of necrosed and perfused areas and the varying degrees of mismatch and overlap, which has prognostic significance. Indium 111 antimyosin imaging is useful in the assessment of patients with unstable angina and in those for whom the diagnosis of infarction or unstable angina is not clear. In suspected myocarditis, a positive scan indicates the necessity for endomyocardial biopsy to confirm inflammation, whereas a negative scan makes the diagnosis of myocarditis unlikely. Antimyosin imaging is not useful as a marker of rejection in the 1 year-post-transplant, but uptake after this period is associated with an increased rejection rate and is therefore an important tool in planning management strategies. Most patients on anthracycline treatment have demonstrable uptake, which is related to the cumulative dose and to the ejection fraction. Its role in this situation is as yet unclear. The use of new ligands and radioisotopes ({sup 99m}Tc) is likely to allow earlier imaging and produce improved quality. (orig.).

  12. Chemical Exchange Saturation Transfer MR Imaging Is Superior to Diffusion Tensor Imaging in the Diagnosis and Severity Evaluation of Parkinson's Disease: a Study on Substantia Nigra and Striatum

    Directory of Open Access Journals (Sweden)

    Chunmei eLi


    Full Text Available Parkinson’s disease (PD is a neurodegenerative disorder characterized by nigrostriatal cell loss. To date the diagnosis of PD is still based primarily on the clinical manifestations which may be typical and obvious only in advanced-stage PD. Thus, it is crucial to find a reliable marker for the diagnosis of PD. We conducted this study to assess the diagnostic efficiency of chemical-exchange-saturation-transfer (CEST imaging and diffusion-tensor imaging (DTI in PD at 3 Tesla by evaluating changes on substantia nigra and striatum. Twenty-three PD patients and twenty-three age-matched normal controls were recruited. All patients and controls were imaged on a 3 Tesla MR system, using an 8-channel head coil. CEST imaging was acquired in two transverse slices of the head, including substantia nigra and striatum. The magnetization-transfer-ratio asymmetry at 3.5 ppm, MTRasym(3.5ppm, and the total CEST signal intensity between 0 and 4 ppm were calculated. Multi-slice DTI was acquired for all the patients and normal controls. Quantitative analysis was performed on the substantia nigra, globus pallidus, putamen and caudate. The MTRasym(3.5ppm value, the total CEST signal intensity and fractional anisotropy (FA value of the substantia nigra were all significantly lower in PD patients than in normal controls (P = 0.003, P = 0.004 and P < 0.001, respectively. The MTRasym(3.5ppm values of the putamen and the caudate were significantly higher in PD patients than in normal controls (P = 0.010 and P = 0.009, respectively. There were no significant differences for the mean diffusivity (MD in these four regions between PD patients and normal controls. In conclusion, CEST MR imaging provided multiple CEST image contrasts in the substantia nigra and the striatum in PD and may be superior to DTI in the diagnosis of PD.

  13. Multimodal imaging of bone metastases: From preclinical to clinical applications

    Directory of Open Access Journals (Sweden)

    Stephan Ellmann


    Full Text Available Metastases to the skeletal system are commonly observed in cancer patients, highly affecting the patients' quality of life. Imaging plays a major role in detection, follow-up, and molecular characterisation of metastatic disease. Thus, imaging techniques have been optimised and combined in a multimodal and multiparametric manner for assessment of complementary aspects in osseous metastases. This review summarises both application of the most relevant imaging techniques for bone metastasis in preclinical models and the clinical setting.

  14. Clinics in diagnostic imaging (58). Chronic cerebral paragonimiasis. (United States)

    Kaw, G J; Sitoh, Y Y


    A 36-year-old Korean man presented with a history of epilepsy. MR imaging of the brain revealed multiple conglomerated round nodules that were hypointense on both T1-and-T2 weighted images. These were located at the left temporal and occipital lobes and had surrounding encephalomalacia. CT scan confirmed the presence of large calcified nodules in the corresponding regions. These imaging findings were typical of chronic cerebral paragonimiasis. The clinical, CT and MR features of cerebral paragonimiasis are reviewed.

  15. Incidental ferumoxytol artifacts in clinical brain MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Bowser, Bruce A.; Campeau, Norbert G.; Carr, Carrie M.; Diehn, Felix E.; McDonald, Jennifer S.; Miller, Gary M.; Kaufmann, Timothy J. [Mayo Clinic, Department of Radiology, Rochester, MN (United States)


    Ferumoxytol (Feraheme) is a parenteral therapy approved for treatment of iron deficiency anemia. The product insert for ferumoxytol states that it may affect the diagnostic ability of MRI for up to 3 months. However, the expected effects may not be commonly recognized among clinical neuroradiologists. Our purpose is to describe the artifacts we have seen at our institution during routine clinical practice. We reviewed the patients at our institution that had brain MRI performed within 90 days of receiving intravenous ferumoxytol. The imaging was reviewed for specific findings, including diffusion-weighted imaging vascular susceptibility artifact, gradient-echo echo-planar T2*-weighted vascular susceptibility artifact, SWI/SWAN vascular susceptibility artifact, hypointense vascular signal on T2-weighted images, pre-gadolinium contrast vascular enhancement on magnetization-prepared rapid acquisition gradient echo (MPRAGE) imaging, and effects on post-gadolinium contrast T1 imaging. Multiple artifacts were observed in patients having a brain MRI within 3 days of receiving intravenous ferumoxytol. These included susceptibility artifact on DWI, GRE, and SWAN/SWI imaging, pre-gadolinium contrast increased vascular signal on MPRAGE imaging, and decreased expected enhancement on post-gadolinium contrast T1-weighted imaging. Ferumoxytol can create imaging artifacts which complicate clinical interpretation when brain MRI is performed within 3 days of administration. Recognition of the constellation of artifacts produced by ferumoxytol is important in order to obviate additional unnecessary examinations and mitigate errors in interpretation. (orig.)

  16. Automated spectral imaging for clinical diagnostics (United States)

    Breneman, John; Heffelfinger, David M.; Pettipiece, Ken; Tsai, Chris; Eden, Peter; Greene, Richard A.; Sorensen, Karen J.; Stubblebine, Will; Witney, Frank


    Bio-Rad Laboratories supplies imaging equipment for many applications in the life sciences. As part of our effort to offer more flexibility to the investigator, we are developing a microscope-based imaging spectrometer for the automated detection and analysis of either conventionally or fluorescently labeled samples. Immediate applications will include the use of fluorescence in situ hybridization (FISH) technology. The field of cytogenetics has benefited greatly from the increased sensitivity of FISH producing simplified analysis of complex chromosomal rearrangements. FISH methods for identification lends itself to automation more easily than the current cytogenetics industry standard of G- banding, however, the methods are complementary. Several technologies have been demonstrated successfully for analyzing the signals from labeled samples, including filter exchanging and interferometry. The detection system lends itself to other fluorescent applications including the display of labeled tissue sections, DNA chips, capillary electrophoresis or any other system using color as an event marker. Enhanced displays of conventionally stained specimens will also be possible.

  17. Cutaneous malignant melanoma: clinical aspects, imaging modalities and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Ak, I.; Stokkel, M.P.M.; Pauwels, E.K.J. [Leiden University Medical Centre, Department of Radiology, Division of Nuclear Medicine, Leiden (Netherlands); Bergman, W. [Department of Dermatology, Leiden University Medical Centre, Leiden (Netherlands)


    Cutaneous melanoma is a highly malignant tumour of the melanocytes presenting characteristic metabolic and biological features. Early detection decreases mortality and morbidity and provides the best chance for optimal clinical management. Imaging techniques, including scintigraphy, have assumed an important role in detection strategies. As a functional modality, nuclear medicine offers a variety of possibilities to assist in the clinical management of malignant melanoma. This review discusses the clinical aspects and treatment of melanoma, and the imaging techniques used for its diagnosis, staging and follow-up. A survey of currently available techniques is presented. (orig.)

  18. Imaging and Data Acquisition in Clinical Trials for Radiation Therapy. (United States)

    FitzGerald, Thomas J; Bishop-Jodoin, Maryann; Followill, David S; Galvin, James; Knopp, Michael V; Michalski, Jeff M; Rosen, Mark A; Bradley, Jeffrey D; Shankar, Lalitha K; Laurie, Fran; Cicchetti, M Giulia; Moni, Janaki; Coleman, C Norman; Deye, James A; Capala, Jacek; Vikram, Bhadrasain


    Cancer treatment evolves through oncology clinical trials. Cancer trials are multimodal and complex. Assuring high-quality data are available to answer not only study objectives but also questions not anticipated at study initiation is the role of quality assurance. The National Cancer Institute reorganized its cancer clinical trials program in 2014. The National Clinical Trials Network (NCTN) was formed and within it was established a Diagnostic Imaging and Radiation Therapy Quality Assurance Organization. This organization is Imaging and Radiation Oncology Core, the Imaging and Radiation Oncology Core Group, consisting of 6 quality assurance centers that provide imaging and radiation therapy quality assurance for the NCTN. Sophisticated imaging is used for cancer diagnosis, treatment, and management as well as for image-driven technologies to plan and execute radiation treatment. Integration of imaging and radiation oncology data acquisition, review, management, and archive strategies are essential for trial compliance and future research. Lessons learned from previous trials are and provide evidence to support diagnostic imaging and radiation therapy data acquisition in NCTN trials.

  19. Role of clinical images based teaching as a supplement to conventional clinical teaching in dermatology

    Directory of Open Access Journals (Sweden)

    Gurumoorthy Rajesh Kumar


    Full Text Available Introduction : Clinical Dermatology is a visually oriented specialty, where visually oriented teaching is more important than it is in any other specialty. It is essential that students must have repeated exposure to common dermatological disorders in the limited hours of Dermatology clinical teaching. Aim: This study was conducted to assess the effect of clinical images based teaching as a supplement to the patient based clinical teaching in Dermatology, among final year MBBS students. Methods: A clinical batch comprising of 19 students was chosen for the study. Apart from the routine clinical teaching sessions, clinical images based teaching was conducted. This teaching method was evaluated using a retrospective pre-post questionnaire. Students′ performance was assessed using Photo Quiz and an Objective Structured Clinical Examination (OSCE. Feedback about the addition of images based class was collected from students. Results: A significant improvement was observed in the self-assessment scores following images based teaching. Mean OSCE score was 6.26/10, and that of Photo Quiz was 13.6/20. Conclusion : This Images based Dermatology teaching has proven to be an excellent supplement to routine clinical cases based teaching.

  20. Clinical image: MRI during migraine with aura

    Energy Technology Data Exchange (ETDEWEB)

    McNeal, A.C. [Brooklyn VA Medical Center, NY (United States)


    Migraine refers to severe headaches that are usually unilateral, throbbing, and associated with nausea, vomiting, photophobia, and phonophobia. Migraine with aura (formerly called {open_quotes}classic migraine{close_quotes}) consists of the headache preceded or accompanied by neurological dysfunction. This dysfunction (aura) usually involves visual and sensory symptoms. The patient described herein experienced migraine with aura. MRI during and after the attack showed a reversible abnormality of the right posterior cerebral artery, with no parenchymal lesions. This appears to be the first report of abnormal MR vascular imaging during migraine with aura. 10 refs., 2 figs.

  1. Photoacoustic imaging system for peripheral small-vessel imaging based on clinical ultrasound technology (United States)

    Irisawa, Kaku; Hirota, Kazuhiro; Hashimoto, Atsushi; Murakoshi, Dai; Ishii, Hiroyasu; Tada, Takuji; Wada, Takatsugu; Hayakawa, Toshiro; Azuma, Ryuichi; Otani, Naoki; Itoh, Kenji; Ishihara, Miya


    One of the features of photoacoustic (PA) imaging is small-vessel visualization realized without injection of a contrast agent or exposure to X-rays. For carrying out clinical studies in this field, a prototype PA imaging system has been developed. The PA imaging system utilizes a technological platform of FUJIFILM's clinical ultrasound (US) imaging system mounting many-core MPU for enhancing the image quality of US B-mode and US Doppler mode, which can be superposed onto PA images. By evaluating the PA and US Doppler images of the prototyped system, the applicability of the prototype system to small-vessel visualization has been discussed. The light source for PA imaging was on a compact cart of a US unit and emitted 750 nm wavelength laser pulses. The laser light was transferred to illumination optics in a handheld US transducer, which was connected to the US unit. Obtained PA rf data is reconstructed into PA images in the US unit. 3D images were obtained by scanning a mechanical stage, which the transducer is attached to. Several peripheral parts such as fingers, palms and wrists were observed by PA and US Doppler imaging. As for small arteries, US Doppler images were able to visualize the bow-shaped artery in the tip of the finger. Though PA images cannot distinguish arteries and veins, it could visualize smaller vessels and showed good resolution and vascular connectivity, resulting in a complementary image for the US Doppler images. Therefore, superposed images of the PA, US B-mode and US Doppler can visualize from large to small vessels without a contrast agent, which should be a differentiating feature of US/PA combined technology from other clinical vascular imaging modalities.

  2. Clinical application of functional magnetic resonance imaging

    CERN Document Server

    Alwatban, A Z W


    The work described in this thesis was carried out at the Magnetic Resonance Centre of the University of Nottingham during the time from May 1998 to April 2001, and is the work of the except where indicated by reference. The main source of signal changes in functional magnetic resonance imaging (fMRJ) is the fluctuation of paramagnetic deoxyhaemoglobin in the venous blood during different states of functional performance. For the work of this thesis, fMRI studies were carried out using a 3 T MR system with an echo planar imaging (EPI) pulse sequence. Hearing research utilising fMRI has been previously reported in normal subjects. Hearing fMRI is normally performed by stimulating the auditory cortex via an acoustic task presentation such as music, tone, etc. However, performing the same research on deaf subjects requires special equipment to be designed to allow direct stimulation of the auditory nerve. In this thesis, a new method of direct electrical stimulation of the auditory nerve is described that uses a ...

  3. Multispectral photoacoustic imaging of nerves with a clinical ultrasound system (United States)

    Mari, Jean Martial; West, Simeon; Beard, Paul C.; Desjardins, Adrien E.


    Accurate and efficient identification of nerves is of great importance during many ultrasound-guided clinical procedures, including nerve blocks and prostate biopsies. It can be challenging to visualise nerves with conventional ultrasound imaging, however. One of the challenges is that nerves can have very similar appearances to nearby structures such as tendons. Several recent studies have highlighted the potential of near-infrared optical spectroscopy for differentiating nerves and adjacent tissues, as this modality can be sensitive to optical absorption of lipids that are present in intra- and extra-neural adipose tissue and in the myelin sheaths. These studies were limited to point measurements, however. In this pilot study, a custom photoacoustic system with a clinical ultrasound imaging probe was used to acquire multi-spectral photoacoustic images of nerves and tendons from swine ex vivo, across the wavelength range of 1100 to 1300 nm. Photoacoustic images were processed and overlaid in colour onto co-registered conventional ultrasound images that were acquired with the same imaging probe. A pronounced optical absorption peak centred at 1210 nm was observed in the photoacoustic signals obtained from nerves, and it was absent in those obtained from tendons. This absorption peak, which is consistent with the presence of lipids, provides a novel image contrast mechanism to significantly enhance the visualization of nerves. In particular, image contrast for nerves was up to 5.5 times greater with photoacoustic imaging (0.82 +/- 0.15) than with conventional ultrasound imaging (0.148 +/- 0.002), with a maximum contrast of 0.95 +/- 0.02 obtained in photoacoustic mode. This pilot study demonstrates the potential of photoacoustic imaging to improve clinical outcomes in ultrasound-guided interventions in regional anaesthesia and interventional oncology.

  4. Clinical application of functional magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Alwatban, Adnan Z.W


    The work described in this thesis was carried out at the Magnetic Resonance Centre of the University of Nottingham during the time from May 1998 to April 2001, and is the work of the author except where indicated by reference. The main source of signal changes in functional magnetic resonance imaging (fMRJ) is the fluctuation of paramagnetic deoxyhaemoglobin in the venous blood during different states of functional performance. For the work of this thesis, fMRI studies were carried out using a 3 T MR system with an echo planar imaging (EPI) pulse sequence. Hearing research utilising fMRI has been previously reported in normal subjects. Hearing fMRI is normally performed by stimulating the auditory cortex via an acoustic task presentation such as music, tone, etc. However, performing the same research on deaf subjects requires special equipment to be designed to allow direct stimulation of the auditory nerve. In this thesis, a new method of direct electrical stimulation of the auditory nerve is described that uses a transtympanic electrode implanted onto the surface of the cochlea. This approach would however, result in electromotive forces (EMFs) being induced by the time varying magnetic field, which would lead to current flow and heating, as well as deflection of the metallic electrode within the static magnetic field, and image distortion due to the magnetic susceptibility difference. A gold-plated tungsten electrode with a zero magnetic susceptibility was developed to avoid image distortion. Used with carbon leads and a carbon reference pad, it enabled safe, distortion-free fMRI studies of deaf subjects. The study revealed activation of the primary auditory cortex. This fMRI procedure can be used to demonstrate whether the auditory pathway is fully intact, and may provide a useful method for pre-operative assessment of candidates for cochlear implantation. Glucose is the energy source on which the function of the human brain is entirely dependent. Failure to

  5. An adaptive optics imaging system designed for clinical use. (United States)

    Zhang, Jie; Yang, Qiang; Saito, Kenichi; Nozato, Koji; Williams, David R; Rossi, Ethan A


    Here we demonstrate a new imaging system that addresses several major problems limiting the clinical utility of conventional adaptive optics scanning light ophthalmoscopy (AOSLO), including its small field of view (FOV), reliance on patient fixation for targeting imaging, and substantial post-processing time. We previously showed an efficient image based eye tracking method for real-time optical stabilization and image registration in AOSLO. However, in patients with poor fixation, eye motion causes the FOV to drift substantially, causing this approach to fail. We solve that problem here by tracking eye motion at multiple spatial scales simultaneously by optically and electronically integrating a wide FOV SLO (WFSLO) with an AOSLO. This multi-scale approach, implemented with fast tip/tilt mirrors, has a large stabilization range of ± 5.6°. Our method consists of three stages implemented in parallel: 1) coarse optical stabilization driven by a WFSLO image, 2) fine optical stabilization driven by an AOSLO image, and 3) sub-pixel digital registration of the AOSLO image. We evaluated system performance in normal eyes and diseased eyes with poor fixation. Residual image motion with incremental compensation after each stage was: 1) ~2-3 arc minutes, (arcmin) 2) ~0.5-0.8 arcmin and, 3) ~0.05-0.07 arcmin, for normal eyes. Performance in eyes with poor fixation was: 1) ~3-5 arcmin, 2) ~0.7-1.1 arcmin and 3) ~0.07-0.14 arcmin. We demonstrate that this system is capable of reducing image motion by a factor of ~400, on average. This new optical design provides additional benefits for clinical imaging, including a steering subsystem for AOSLO that can be guided by the WFSLO to target specific regions of interest such as retinal pathology and real-time averaging of registered images to eliminate image post-processing.

  6. Modern Trends in Imaging X: Spectral Imaging in Preclinical Research and Clinical Pathology

    Directory of Open Access Journals (Sweden)

    Richard Levenson


    Full Text Available Spectral imaging methods are attracting increased interest from researchers and practitioners in basic science, pre-clinical and clinical arenas. A combination of better labeling reagents and better optics creates opportunities to detect and measure multiple parameters at the molecular and cellular level. These tools can provide valuable insights into the basic mechanisms of life, and yield diagnostic and prognostic information for clinical applications. There are many multispectral technologies available, each with its own advantages and limitations. This chapter will present an overview of the rationale for spectral imaging, and discuss the hardware, software and sample labeling strategies that can optimize its usefulness in clinical settings.

  7. Clinical applications for diffusion magnetic resonance imaging in radiotherapy. (United States)

    Tsien, Christina; Cao, Yue; Chenevert, Thomas


    In this article, we review the clinical applications of diffusion magnetic resonance imaging (MRI) in the radiotherapy treatment of several key clinical sites, including those of the central nervous system, the head and neck, the prostate, and the cervix. Diffusion-weighted MRI (DWI) is an imaging technique that is rapidly gaining widespread acceptance owing to its ease and wide availability. DWI measures the mobility of water within tissue at the cellular level without the need of any exogenous contrast agent. For radiotherapy treatment planning, DWI improves upon conventional imaging techniques, by better characterization of tumor tissue properties required for tumor grading, diagnosis, and target volume delineation. Because DWI is also a sensitive marker for alterations in tumor cellularity, it has potential clinical applications in the early assessment of treatment response following radiation therapy.

  8. NMR clinical imaging and spectroscopy: Its impact on nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)


    This is a collection of four papers describing aspects of past and future use of nuclear magnetic resonance as a clinical diagnostic tool. The four papers are entitled (1) What Does NMR Offer that Nuclear Medicine Does Not by Jerry W. Froelich, (2) Oncological Imaging: Now, Future and Impact Jerry W. Froelich, (3) Magnetic Resonance Spectroscopy/Spectroscopic Imaging and Nuclear Medicine: Past, Present and Future by H. Cecil Charles, and (4) MR Cardiology: Now, Future and Impact by Robert J. Herfkens.

  9. NMR clinical imaging and spectroscopy: Its impact on nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)


    This is a collection of four papers describing aspects of past and future use of nuclear magnetic resonance as a clinical diagnostic tool. The four papers are entitled (1) What Does NMR Offer that Nuclear Medicine Does Not? by Jerry W. Froelich, (2) Oncological Imaging: Now, Future and Impact Jerry W. Froelich, (3) Magnetic Resonance Spectroscopy/Spectroscopic Imaging and Nuclear Medicine: Past, Present and Future by H. Cecil Charles, and (4) MR Cardiology: Now, Future and Impact by Robert J. Herfkens.

  10. First-in-human clinical trials of imaging devices: an example from optical imaging. (United States)

    Gibbs-Strauss, Summer L; Rosenberg, Mireille; Clough, Barbara L; Troyan, Susan L; Frangioni, John V


    Clinical translation of scientific discoveries is often the long-term goal of academic medical research. However, this goal is not always realized due to the complicated path between bench research and clinical use. In this review, we outline the fundamental steps required for first-in-human testing of a new imaging device, and use the FLARE() (Fluorescence-Assisted Resection and Exploration) near-infrared fluorescence optical imaging platform as an example.

  11. Clinical and imaging assessment of cognitive dysfunction in multiple sclerosis

    DEFF Research Database (Denmark)

    Rocca, Maria A; Amato, Maria P; De Stefano, Nicola


    In patients with multiple sclerosis (MS), grey matter damage is widespread and might underlie many of the clinical symptoms, especially cognitive impairment. This relation between grey matter damage and cognitive impairment has been lent support by findings from clinical and MRI studies. However...... with MS than exists at present. Imaging measures of the grey matter are necessary, but not sufficient to fully characterise cognitive decline in MS. Imaging measures of both lesioned and normal-appearing white matter lend support to the hypothesis of the existence of an underlying disconnection syndrome...

  12. Fat saturation in dynamic breast MRI at 3 Tesla: is the Dixon technique superior to spectral fat saturation? A visual grading characteristics study

    Energy Technology Data Exchange (ETDEWEB)

    Clauser, P. [University of Udine, Azienda Ospedaliero-Universitaria ' ' S.Maria della Misericordia' ' , Institute of Diagnostic Radiology, Udine (Italy); Medical University of Vienna, Department of Biomedical Imaging and Image-guided interventions, Division of Molecular and Gender Imaging, Vienna (Austria); Pinker, K.; Helbich, T.H.; Kapetas, P.; Bernathova, M.; Baltzer, P.A.T. [Medical University of Vienna, Department of Biomedical Imaging and Image-guided interventions, Division of Molecular and Gender Imaging, Vienna (Austria)


    To intra-individually compare the diagnostic image quality of Dixon and spectral fat suppression at 3 T. Fifty consecutive patients (mean age 55.1 years) undergoing 3 T breast MRI were recruited for this prospective study. The image protocol included pre-contrast and delayed post-contrast spectral and Dixon fat-suppressed T1w series. Two independent blinded readers compared spectral and Dixon fat-suppressed series by evaluating six ordinal (1 worst to 5 best) image quality criteria (image quality, delineation of anatomical structures, fat suppression in the breast and axilla, lesion delineation and internal enhancement). Breast density and size were assessed. Data analysis included Spearman's rank correlation coefficient and visual grading characteristics (VGC) analysis. Four examinations were excluded; 48 examinations in 46 patients were evaluated. In VGC analysis, the Dixon technique was superior regarding image quality criteria analysed (P < 0.01). Smaller breast size and lower breast density were significantly (P < 0.01) correlated with impaired spectral fat suppression quality. No such correlation was identified for the Dixon technique, which showed reconstruction-based water-fat mixups leading to insufficient image quality in 20.8 %. The Dixon technique outperformed spectral fat suppression in all evaluated criteria (P < 0.01). Non-diagnostic examinations can be avoided by fat and water image reconstruction. The superior image quality of the Dixon technique can improve breast MRI interpretation. (orig.)

  13. Diffusion Tensor Imaging: Exploring the Motor Networks and Clinical Applications

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Sung Soo; Lee, Seung Koo [Yonsei University College of Medicine, Seoul (Korea, Republic of)


    With the advances in diffusion magnetic resonance (MR) imaging techniques, diffusion tensor imaging (DTI) has been applied to a number of neurological conditions because DTI can demonstrate microstructures of the brain that are not assessable with conventional MR imaging. Tractography based on DTI offers gross visualization of the white matter fiber architecture in the human brain in vivo. Degradation of restrictive barriers and disruption of the cytoarchitecture result in changes in the diffusion of water molecules in various pathological conditions, and these conditions can also be assessed with DTI. Yet many factors may influence the ability to apply DTI clinically, so these techniques have to be used with a cautious hand.

  14. Clinical applications of imaging biomarkers. Part 1. The neuroradiologist's perspective


    Smith, E T S


    This article is concerned with the application and usage in clinical practice of techniques of detection and measurement of imaging biomarkers. Some commentaries in the article derive from a literature search and include summaries of recently published material compiled and linked to each other by extensive use of the text contained in the material examined.

  15. Recent advances in medical imaging: anatomical and clinical applications. (United States)

    Grignon, Bruno; Mainard, Laurence; Delion, Matthieu; Hodez, Claude; Oldrini, Guillaume


    The aim of this paper was to present an overview of the most important recent advances in medical imaging and their potential clinical and anatomical applications. Dramatic changes have been particularly observed in the field of computed tomography (CT) and magnetic resonance imaging (MRI). Computed tomography (CT) has been completely overturned by the successive development of helical acquisition, multidetector and large area-detector acquisition. Visualising brain function has become a new challenge for MRI, which is called functional MRI, currently based principally on blood oxygenation level-dependent sequences, which could be completed or replaced by other techniques such as diffusion MRI (DWI). Based on molecular diffusion due to the thermal energy of free water, DWI offers a spectrum of anatomical and clinical applications, ranging from brain ischemia to visualisation of large fibrous structures of the human body such as the anatomical bundles of white matter with diffusion tensor imaging and tractography. In the field of X-ray projection imaging, a new low-dose device called EOS has been developed through new highly sensitive detectors of X-rays, allowing for acquiring frontal and lateral images simultaneously. Other improvements have been briefly mentioned. Technical principles have been considered in order to understand what is most useful in clinical practice as well as in the field of anatomical applications. Nuclear medicine has not been included.

  16. MR imaging and clinical findings of spontaneous spinal epidural hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sam Soo [Seoul City Boramae Hospital, Seoul (Korea, Republic of); Han, Moon Hee; Kim, Hyun Beom [College of Medicine, Seoul National University, Seoul (Korea, Republic of)] [and others


    To describe the MR imaging and clinical findings of spontaneous spinal epidural hematoma. The MR and clinical findings in six patients (M:F=3D4:2;adult:child=3D3:3) with spontaneous spinal epidural hematoma were reviewed. Five patients without any predisposing factor which might cause the condition and one with acute myelogenous leukemia were included. Emergency surgery was performed in two patients, and the other four were managed conservatively. The epidural lesion involved between three and seven vertebrae (mean:4.5), and relative to the spinal cord was located in the posterior-lateral (n=3D4), anterior (n=3D1), or right lateral (n=3D1) area. The hematoma was isointense (n=3D1) or hyperintense (n=3D5) with spinal cord on T1-weighted images, and hypointense (n=3D2) or hyperintense (n=3D4) on T2-weighted images. It was completely absorbed in four of five patients who underwent follow-up MR imaging, but not changed in one. The clinical outcome of these patients was complete recovery (n=3D4), spastic cerebral palsy (n=3D1), or unknown (n=3D1). Because of the lesion's characteristic signal intensity; MR imaging is very useful in the diagnosis and evaluation of spontaneous spinal epidural hematoma. (author)

  17. Normal feline brain: clinical anatomy using magnetic resonance imaging. (United States)

    Mogicato, G; Conchou, F; Layssol-Lamour, C; Raharison, F; Sautet, J


    The purpose of this study was to provide a clinical anatomy atlas of the feline brain using magnetic resonance imaging (MRI). Brains of twelve normal cats were imaged using a 1.5 T magnetic resonance unit and an inversion/recovery sequence (T1). Fourteen relevant MRI sections were chosen in transverse, dorsal, median and sagittal planes. Anatomic structures were identified and labelled using anatomical texts and Nomina Anatomica Veterinaria, sectioned specimen heads, and previously published articles. The MRI sections were stained according to the major embryological and anatomical subdivisions of the brain. The relevant anatomical structures seen on MRI will assist clinicians to better understand MR images and to relate this neuro-anatomy to clinical signs.

  18. Imaging of cystic fibrosis lung disease and clinical interpretation

    Energy Technology Data Exchange (ETDEWEB)

    Wielpuetz, M.O.; Eichinger, M.; Kauczor, H.U. [Heidelberg University Hospital (Germany). Dept. of Diagnostic and Interventional Radiology; Translational Lung Research Center Heidelberg (TLRC) (Germany); Heidelberg University Hospital (Germany). Dept. of Diagnostic and Interventional Radiology with Nuclear Medicine; Biederer, J. [Heidelberg University Hospital (Germany). Dept. of Diagnostic and Interventional Radiology; Translational Lung Research Center Heidelberg (TLRC) (Germany); Gross-Gerau Community Hospital (Germany). Radiologie Darmstadt; Wege, S. [Heidelberg University Hospital (Germany). Dept. of Pulmonology and Respiratory Medicine; Stahl, M.; Sommerburg, O. [Translational Lung Research Center Heidelberg (TLRC) (Germany); Heidelberg University Hospital (Germany). Div. of Pediatric Pulmonology and Allergy and Cystic Fibrosis Center; Mall, M.A. [Translational Lung Research Center Heidelberg (TLRC) (Germany); Heidelberg University Hospital (Germany). Div. of Pediatric Pulmonology and Allergy and Cystic Fibrosis Center; Heidelberg University Hospital (Germany). Dept. of Translational Pulmonology; Puderbach, M. [Heidelberg University Hospital (Germany). Dept. of Diagnostic and Interventional Radiology; Translational Lung Research Center Heidelberg (TLRC) (Germany); Heidelberg University Hospital (Germany). Dept. of Diagnostic and Interventional Radiology with Nuclear Medicine; Hufeland Hospital, Bad Langensalza (Germany). Dept. of Diagnostic and Interventional Radiology


    Progressive lung disease in cystic fibrosis (CF) is the life-limiting factor of this autosomal recessive genetic disorder. Increasing implementation of CF newborn screening allows for a diagnosis even in pre-symptomatic stages. Improvements in therapy have led to a significant improvement in survival, the majority now being of adult age. Imaging provides detailed information on the regional distribution of CF lung disease, hence longitudinal imaging is recommended for disease monitoring in the clinical routine. Chest X-ray (CXR), computed tomography (CT) and magnetic resonance imaging (MRI) are now available as routine modalities, each with individual strengths and drawbacks, which need to be considered when choosing the optimal modality adapted to the clinical situation of the patient. CT stands out with the highest morphological detail and has often been a substitute for CXR for regular severity monitoring at specialized centers. Multidetector CT data can be post-processed with dedicated software for a detailed measurement of airway dimensions and bronchiectasis and potentially a more objective and precise grading of disease severity. However, changing to CT was inseparably accompanied by an increase in radiation exposure of CF patients, a young population with high sensitivity to ionizing radiation and lifetime accumulation of dose. MRI as a cross-sectional imaging modality free of ionizing radiation can depict morphological hallmarks of CF lung disease at lower spatial resolution but excels with comprehensive functional lung imaging, with time-resolved perfusion imaging currently being most valuable.

  19. Matching the Clinical Question to the Appropriate Imaging Procedure: What a Cardiologist Wants from Cardiac Imaging

    Directory of Open Access Journals (Sweden)

    S. Wann


    Full Text Available In modern medicine, we too often become enamored with technology and lose focus on the reason for per-forming a diagnostic study. Cardiac imaging may have advanced to point of replacing the physical ex-amination, but there is still no substitute for thought-ful planning of a diagnostic approach based on a hier-archy of clinical data, an appreciation of the pre-test likelihood of disease, realistic expectation from vari-ous imaging procedures, and a rational plan for utiliz-ing the information gained. Team work is required to effectively utilize all the capabilities of the modern medical environment. Communication is essential if patients are to receive the best care. As the power and complexity of imag-ing has increase, so has its over-utilization. This lec-ture will focus on maximizing useful diagnostic yield, while minimizing redundancy and excessive costs. While evidence based medical practice is ideally based on controlled randomized trials to show im-proved patient outcomes. Medical imaging has his-torically developed by improving the quality of im-ages, comparing new to existing technologist. Exam-ples will be given of applications of various imaging techniques to common clinical problems, pointing out areas where true evidence is lacking. Appropriate imaging in these situations must be defined by con-sensus of expert opinion. A variety of clinical vi-gnettes will be presented.

  20. Magnetic resonance imaging for prostate cancer clinical application

    Institute of Scientific and Technical Information of China (English)

    Bing Li; Yong Du; Hanfeng Yang; Yayong Huang; Jun Meng; Dongmei Xiao


    As prostate cancer is a biologically heterogeneous disease for which a variety of treatment options are available,the major objective of prostate cancer imaging is to achieve more precise disease characterization.In clinical practice,magnetic resonance imaging (MRI) is one of the imaging tools for the evaluation of prostate cancer,the fusion of MRI or dynamic contrast-enhanced MRI (DCE-MRI) with magnetic resonance spectroscopic imaging (MRSI) is improving the evaluation of cancer location,size,and extent,while providing an indication of tumor aggressiveness.This review summarizes the role of MRI in the application of prostate cancer and describes molecular MRI techniques (including MRSI and DCE-MRI)for aiding prostate cancer management.

  1. Nuclear Breast Imaging: Clinical Results and Future Directions. (United States)

    Berg, Wendie A


    Interest in nuclear breast imaging is increasing because of technical improvements in dedicated devices that allow the use of relatively low doses of radiotracers with high sensitivity for even small breast cancers. For women with newly diagnosed cancer, primary chemotherapy is often recommended, and improved methods of assessing treatment response are of interest. With widespread breast density notification, functional rather than anatomic methods of screening are of increasing interest as well. For a cancer imaging technology to be adopted, several criteria must be met that will be discussed: evidence of clinical benefit with minimal harm, standardized interpretive criteria, direct biopsy guidance, and acceptable cost-effectiveness.

  2. Clinical applications of diffusion imaging in the spine. (United States)

    Tanenbaum, Lawrence N


    As in the brain, the sensitivity of diffusion-weighted imaging (DWI) to ischemic damage in the spinal cord may provide early identification of infarction. Diffusion anisotropy may enhance the detection and understanding of damage to the long fiber tracts with clinical implications for diseases such as multiple sclerosis and amyotrophic lateral sclerosis and may also yield insight into damage that occurs with spondylotic and traumatic myelopathy. This article reviews the basis for DWI for the evaluation of the spinal cord, osseous, and soft tissues of the spine and reviews the imaging appearance of a variety of disease states.

  3. Development of photoacoustic imaging technology overlaid on ultrasound imaging and its clinical application (United States)

    Ishihara, Miya; Tsujita, Kazuhiro; Horiguchi, Akio; Irisawa, Kaku; Komatsu, Tomohiro; Ayaori, Makoto; Hirasawa, Takeshi; Kasamatsu, Tadashi; Hirota, Kazuhiro; Tsuda, Hitoshi; Ikewaki, Katsunori; Asano, Tomohiko


    Purpose: Photoacoustic imaging (PAI) enables one to visualize the distribution of hemoglobin and acquire a map of microvessels without using contrast agents. The purpose of our study is to develop a clinically applicable PAI system integrated with a clinical ultrasound (US) array system with handheld PAI probes providing coregistered PAI and US images. Clinical research trials were performed to evaluate the performance and feasibility of clinical value. Materials and Methods: We developed two types of handheld PAI probes: a linear PAI probe combining a conventional linear-array US probe with optical illumination and a transrectal ultrasonography (TRUS)-type PAI probe. We performed experiments with Japanese white rabbits and conducted clinical research trials of urology and vascular medicine with the approval of the medical human ethics committee of the National Defense Medical College. Results: We successfully acquired high-dynamic-range images of the vascular network ranging from capillaries to landmark arteries and identified the femoral vein, deep femoral vein, and great saphenous vein of rabbits. These major vessels in the rabbits groin are surrounded with microvessels connected to each other. Periprostatic microvessels were monitored during radical prostatectomy for localized prostate cancer and they were colocalized with nerve fibers, and their distribution was consistent with the corresponding PAI. The TRUS-type PAI probe clearly demonstrated the location and extent of the neurovascular bundle (NVB) better than does TRUS alone. Conclusions: The system, which can obtain a PAI, a US image, and a merged image, was innovatively designed so that medical doctors can easily find the location without any prior knowledge or extended skills to analyze the obtained images. Our pilot feasibility study confirms that PAI could be an imaging modality useful in the screening study and diagnostic biopsy.

  4. Breast imaging with SoftVue: initial clinical evaluation (United States)

    Duric, Neb; Littrup, Peter; Li, Cuiping; Roy, Olivier; Schmidt, Steven; Cheng, Xiaoyang; Seamans, John; Wallen, Andrea; Bey-Knight, Lisa


    We describe the clinical performance of SoftVue, a breast imaging device based on the principles of ultrasound tomography. Participants were enrolled in an IRB-approved study at Wayne State University, Detroit, MI. The main research findings indicate that SoftVue is able to image the whole uncompressed breast up to cup size H. Masses can be imaged in even the densest breasts with the ability to discern margins and mass shapes. Additionally, it is demonstrated that multi-focal disease can also be imaged. The system was also tested in its research mode for additional imaging capabilities. These tests demonstrated the potential for generating tissue stiffness information for the entire breast using through-transmission data. This research capability differentiates SoftVue from the other whole breast systems on the market. It is also shown that MRI-like images can be generated using alternative processing of the echo data. Ongoing research is focused on validating and quantifying these findings in a larger sample of study participants and quantifying SoftVue's ability to differentiate benign masses from cancer.

  5. Clinics in diagnostic imaging (82). Lesser trochanter metastasis. (United States)

    Peh, W C G; Muttarak, M


    A 73-year-old woman who had previous mastectomy for breast carcinoma presented with persistent pain over the left hip area for two to three months. Pelvic radiograph showed an expanded osteolytic lesion involving the lesser trochanter of the left femur, with adjacent ill-defined destructive changes. She subsequently developed a displaced pathological fracture through the lesser trochanteric metastasis. The clinical features and pathophysiology of bone metastases are discussed. The role of imaging, with additional illustrative examples, is emphasised.

  6. Sodium-23 MRI of whole spine at 3 Tesla using a 5-channel receive-only phased-array and a whole-body transmit resonator

    Energy Technology Data Exchange (ETDEWEB)

    Malzacher, Matthias; Kalayciyan, Raffi; Konstandin, Simon; Schad, Lothar R. [Heidelberg Univ., Mannheim (Germany). Computer Assisted Clinical Medicine; Haneder, Stefan [Heidelberg Univ., Mannheim (Germany). Clinical Radiology and Nuclear Medicine; University Hospital of Cologne, Koeln (Germany). Dept. of Radiology


    Sodium magnetic resonance imaging ({sup 23}Na MRI) is a unique and non-invasive imaging technique which provides important information on cellular level about the tissue of the human body. Several applications for {sup 23}Na MRI were investigated with regard to the examination of the tissue viability and functionality for example in the brain, the heart or the breast. The {sup 23}Na MRI technique can also be integrated as a potential monitoring instrument after radiotherapy or chemotherapy. The main contribution in this work was the adaptation of {sup 23}Na MRI for spine imaging, which can provide essential information on the integrity of the intervertebral disks with respect to the early detection of disk degeneration. In this work, a transmit-only receive-only dual resonator system was designed and developed to cover the whole human spine using {sup 23}Na MRI and increase the receive sensitivity. The resonator system consisted of an already presented {sup 23}Na whole-body resonator and a newly developed 5-channel receive-only phased-array. The resonator system was first validated using bench top and phantom measurements. A threefold SNR improvement at the depth of the spine (∝7 cm) over the whole-body resonator was achieved using the spine array. {sup 23}Na MR measurements of the human spine using the transmit-only receive-only resonator system were performed on a healthy volunteer within an acquisition time of 10 minutes. A density adapted 3D radial sequence was chosen with 6 mm isotropic resolution, 49 ms repetition time and a short echo time of 540 μs. Furthermore, it was possible to quantify the tissue sodium concentration in the intervertebral discs in the lumbar region (120 ms repetition time) using this setup.

  7. Moxifloxacin: Clinically compatible contrast agent for multiphoton imaging (United States)

    Wang, Taejun; Jang, Won Hyuk; Lee, Seunghun; Yoon, Calvin J.; Lee, Jun Ho; Kim, Bumju; Hwang, Sekyu; Hong, Chun-Pyo; Yoon, Yeoreum; Lee, Gilgu; Le, Viet-Hoan; Bok, Seoyeon; Ahn, G.-One; Lee, Jaewook; Gho, Yong Song; Chung, Euiheon; Kim, Sungjee; Jang, Myoung Ho; Myung, Seung-Jae; Kim, Myoung Joon; So, Peter T. C.; Kim, Ki Hean


    Multiphoton microscopy (MPM) is a nonlinear fluorescence microscopic technique widely used for cellular imaging of thick tissues and live animals in biological studies. However, MPM application to human tissues is limited by weak endogenous fluorescence in tissue and cytotoxicity of exogenous probes. Herein, we describe the applications of moxifloxacin, an FDA-approved antibiotic, as a cell-labeling agent for MPM. Moxifloxacin has bright intrinsic multiphoton fluorescence, good tissue penetration and high intracellular concentration. MPM with moxifloxacin was demonstrated in various cell lines, and animal tissues of cornea, skin, small intestine and bladder. Clinical application is promising since imaging based on moxifloxacin labeling could be 10 times faster than imaging based on endogenous fluorescence.

  8. Clinical benefits of diffusion tensor imaging in hydrocephalus. (United States)

    Ben-Sira, Liat; Goder, Noam; Bassan, Haim; Lifshits, Shlomi; Assaf, Yaniv; Constantini, Shlomi


    OBJECT The object of this study was to use diffusion tensor imaging (DTI) to evaluate and characterize white matter changes in hydrocephalus. METHODS The authors performed a retrospective analysis of DTI in a cohort of patients with hydrocephalus (n = 35), 19 of whom had both pre- and postsurgical imaging studies. These patient's DTI values were compared with values extracted from age-dependent trend lines computed from a healthy subject group (n = 70, age span 14 months-14 years). Several DTI parameters in different regions of interest (ROIs) were evaluated to find the most sensitive parameters for clinical decision making in hydrocephalus. RESULTS Compared with healthy controls, patients with active hydrocephalus had a statistically significant change in all DTI parameters. The most sensitive and specific DTI parameter for predicting hydrocephalus was axial diffusivity (λ1) measured at the level of the corona radiata. Diffusion tensor imaging parameters correlated with several conventional radiological parameters in the assessment of hydrocephalus but were not superior to them. There was no convincing correlation between clinical disease severity and DTI parameters. When examining the pre- and postsurgical effect, it was found that DTI may be a sensitive tool for estimating tissue improvement. CONCLUSIONS This large-cohort study with a multidisciplinary approach combining clinical, neurological, radiological, and multiple DTI parameters revealed the most sensitive DTI parameters for identifying hydrocephalus and suggested that they may serve as an important tool for the disorder's quantitative radiological assessment.

  9. Spinal cord ischemia: aetiology, clinical syndromes and imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Weidauer, Stefan [Frankfurt Univ., Sankt Katharinen Hospital Teaching Hospital, Frankfurt am Main (Germany). Dept. of Neurology; Hattingen, Elke; Berkefeld, Joachim [Frankfurt Univ., Frankfurt am Main (Germany). Inst. of Neuroradiology; Nichtweiss, Michael


    The purpose of this study was to analyse MR imaging features and lesion patterns as defined by compromised vascular territories, correlating them to different clinical syndromes and aetiological aspects. In a 19.8-year period, clinical records and magnetic resonance imaging (MRI) features of 55 consecutive patients suffering from spinal cord ischemia were evaluated. Aetiologies of infarcts were arteriosclerosis of the aorta and vertebral arteries (23.6 %), aortic surgery or interventional aneurysm repair (11 %) and aortic and vertebral artery dissection (11 %), and in 23.6 %, aetiology remained unclear. Infarcts occurred in 38.2 % at the cervical and thoracic level, respectively, and 49 % of patients suffered from centromedullar syndrome caused by anterior spinal artery ischemia. MRI disclosed hyperintense pencil-like lesion pattern on T2WI in 98.2 %, cord swelling in 40 %, enhancement on post-contrast T1WI in 42.9 % and always hyperintense signal on diffusion-weighted imaging (DWI) when acquired. The most common clinical feature in spinal cord ischemia is a centromedullar syndrome, and in contrast to anterior spinal artery ischemia, infarcts in the posterior spinal artery territory are rare. The exclusively cervical location of the spinal sulcal artery syndrome seems to be a likely consequence of anterior spinal artery duplication which is observed preferentially here. (orig.)

  10. Evaluation of aqueductal patency in patients with hydrocephalus: Three-dimensional high-sampling efficiency technique(SPACE) versus two-dimensional turbo spin echo at 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Ucar, Murat; Guryildirim, Melike; Tokgoz, Nil; Kilic, Koray; Borcek, Alp; Oner, Yusuf; Akkan, Koray; Tali, Turgut [School of Medicine, Gazi University, Ankara (Turkey)


    To compare the accuracy of diagnosing aqueductal patency and image quality between high spatial resolution three-dimensional (3D) high-sampling-efficiency technique (sampling perfection with application optimized contrast using different flip angle evolutions [SPACE]) and T2-weighted (T2W) two-dimensional (2D) turbo spin echo (TSE) at 3-T in patients with hydrocephalus. This retrospective study included 99 patients diagnosed with hydrocephalus. T2W 3D-SPACE was added to the routine sequences which consisted of T2W 2D-TSE, 3D-constructive interference steady state (CISS), and cine phase-contrast MRI (PC-MRI). Two radiologists evaluated independently the patency of cerebral aqueduct and image quality on the T2W 2D-TSE and T2W 3D-SPACE. PC-MRI and 3D-CISS were used as the reference for aqueductal patency and image quality, respectively. Inter-observer agreement was calculated using kappa statistics. The evaluation of the aqueductal patency by T2W 3D-SPACE and T2W 2D-TSE were in agreement with PC-MRI in 100% (99/99; sensitivity, 100% [83/83]; specificity, 100% [16/16]) and 83.8% (83/99; sensitivity, 100% [67/83]; specificity, 100% [16/16]), respectively (p < 0.001). No significant difference in image quality between T2W 2D-TSE and T2W 3D-SPACE (p = 0.056) occurred. The kappa values for inter-observer agreement were 0.714 for T2W 2D-TSE and 0.899 for T2W 3D-SPACE. Three-dimensional-SPACE is superior to 2D-TSE for the evaluation of aqueductal patency in hydrocephalus. T2W 3D-SPACE may hold promise as a highly accurate alternative treatment to PC-MRI for the physiological and morphological evaluation of aqueductal patency.

  11. Iliac vein compression syndrome: Clinical, imaging and pathologic findings

    Institute of Scientific and Technical Information of China (English)

    Katelyn; N; Brinegar; Rahul; A; Sheth; Ali; Khademhosseini; Jemianne; Bautista; Rahmi; Oklu


    May-Thurner syndrome(MTS) is the pathologic compression of the left common iliac vein by the right common iliac artery, resulting in left lower extremity pain, swelling, and deep venous thrombosis. Though this syndrome was first described in 1851, there are currently no standardized criteria to establish the diagnosis of MTS. Since MTS is treated by a wide array of specialties, including interventional radiology, vascular surgery, cardiology, and vascular medicine, the need for an established diagnostic criterion is imperative in order to reduce misdiagnosis and inappropriate treatment. Although MTS has historically been diagnosed by the presence of pathologic features, the use of dynamic imaging techniques has led to a more radiologic based diagnosis. Thus, imaging plays an integral part in screening patients for MTS, and the utility of a wide array of imaging modalities has been evaluated. Here, we summarize the historical aspects of the clinical features of this syndrome. We then provide a comprehensive assessment of the literature on the efficacy of imaging tools available to diagnose MTS. Lastly, we provide clinical pearls and recommendations to aid physicians in diagnosing the syndrome through the use of provocative measures.

  12. 3-Tesla MRI によって責任病巣が確定できた外転神経麻痺型片頭痛の1例


    神原, 啓輔; 橋本, 雅人; 大黒, 浩; 久原, 真


    今回我々は片頭痛後に外転神経麻痺を繰り返し発症し、3-Tesla MRI において外転神経麻痺の責任病巣を確定できた眼筋麻痺性片頭痛の1例を経験したので報告する。症例は14歳の女児。幼少時より片頭痛に伴う眼球運動障害を繰り返し発症していた既往がある。平成23年秋に片頭痛に伴い水平性複視が出現。神経眼科的所見としては左外転神経麻痺を認め、脳幹部画像検索を行った。3-Tesla MRI におけるFIESTA-C thinスライス(0.3mm 厚)画像では、外転神経に平行な斜め水平断において、左外転神経根出口部(root exit zone)が局所的に腫大し、さらに造影SPGR 法において同部位が著明な造影効果を示した。またFLAIR 法において大脳皮質に脱髄斑を認めた。これらの画像および臨床所見より、眼筋麻痺性片頭痛および多発性硬化症と診断した。ステロイドの全身投与を行ったところ、外転神経麻痺の改善がみられ、画像検査においても左外転神経根の造影効果は減少した。近年、眼筋麻痺性片頭痛のMRI 画像の特徴として動眼神経根出口部の菱形様腫脹および造影効果が報告されている。本症も外転神経根に...

  13. Dynamic Contrast-Enhanced MRI Parameters as Biomarkers in Assessing Head and Neck Lesions After Chemoradiotherapy Using a Wide-Bore 3 Tesla Scanner. (United States)

    Lerant, Gergely; Sarkozy, Peter; Takacsi-Nagy, Zoltan; Polony, Gabor; Tamas, Laszlo; Toth, Erika; Boer, Andras; Javor, Laszlo; Godeny, Maria


    Pilot studies have shown promising results in characterizing head and neck tumors (HNT) using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), differentiating between malignant and benign lesions and evaluating changes in response to chemoradiotherapy (CRT). Our aim was to find DCE-MRI parameters, biomarkers in evaluating the post-CRT status. Two hundred and five patients with head and neck lesions were examined with DCE-MRI sequences. The time intensity curves (TIC) were extracted and processed to acquire time-to-peak (TTP), relative maximum enhancement (RME), relative wash-out (RWO), and two new parameters attack and decay. These parameters were analyzed using univariate tests in SPSS (Statistical Package for the Social Sciences, version 17, SPSS Inc. Chicago, USA) to identify parameters that could be used to infer tumor malignancy and post-CRT changes. Multiple parameters of curve characteristics were significantly different between malignant tumors after CRT (MACRT) and changes caused by CRT. The best-performing biomarkers were the attack and the decay. We also found multiple significant (p < 0.05) parameters for both the benign and malignant status as well as pre- and post-CRT status. Our large cohort of data supports the increasing role of DCE-MRI in HNT differentiation, particularly for the assessment of post-CRT status along with accurate morphological imaging.

  14. Building blocks for a clinical imaging informatics environment. (United States)

    Kohli, Marc D; Warnock, Max; Daly, Mark; Toland, Christopher; Meenan, Chris; Nagy, Paul G


    Over the past 20 years, imaging informatics has been driven by the widespread adoption of radiology information and picture archiving and communication and speech recognition systems. These three clinical information systems are commonplace and are intuitive to most radiologists as they replicate familiar paper and film workflow. So what is next? There is a surge of innovation in imaging informatics around advanced workflow, search, electronic medical record aggregation, dashboarding, and analytics tools for quality measures (Nance et al., AJR Am J Roentgenol 200:1064-1070, 2013). The challenge lies in not having to rebuild the technological wheel for each of these new applications but instead attempt to share common components through open standards and modern development techniques. The next generation of applications will be built with moving parts that work together to satisfy advanced use cases without replicating databases and without requiring fragile, intense synchronization from clinical systems. The purpose of this paper is to identify building blocks that can position a practice to be able to quickly innovate when addressing clinical, educational, and research-related problems. This paper is the result of identifying common components in the construction of over two dozen clinical informatics projects developed at the University of Maryland Radiology Informatics Research Laboratory. The systems outlined are intended as a mere foundation rather than an exhaustive list of possible extensions.

  15. 'Ready-access' CT imaging for an orthopaedic trauma clinic.

    LENUS (Irish Health Repository)

    Cawley, D


    \\'Ready-Access\\' to CT imaging facilities in Orthopaedic Trauma Clinics is not a standard facility. This facility has been available at the regional trauma unit, in Merlin Park Hospital, Galway for the past four years. We reviewed the use of this facility over a 2-year period when 100 patients had CT scans as part of their trauma clinic assessment. The rate of CT scan per clinic was 0.6. The mean waiting time for a CT scan was 30 minutes. 20 (20%) new fractures were confirmed, 33 (33%) fractures were out-ruled, 25 (25%) fractures demonstrated additional information and 8 (8%) had additional fractures. 20 (20%) patients were discharged and 12 (12%) patients were admitted as a result of the CT scan. It adds little time and cost to CT scanning lists.

  16. The image schema and innate archetypes: theoretical and clinical implications. (United States)

    Merchant, John


    Based in contemporary neuroscience, Jean Knox's 2004 JAP paper 'From archetypes to reflective function' honed her position on image schemas, thereby introducing a model for archetypes which sees them as 'reliably repeated early developmental achievements' and not as genetically inherited, innate psychic structures. The image schema model is used to illustrate how the analyst worked with a patient who began life as an unwanted pregnancy, was adopted at birth and as an adult experienced profound synchronicities, paranormal/telepathic phenomena and visions. The classical approach to such phenomena would see the intense affectivity arising out of a ruptured symbiotic mother-infant relationship constellating certain archetypes which set up the patient's visions. This view is contrasted with Knox's model which sees the archetype an sich as a developmentally produced image schema underpinning the emergence of later imagery. The patient's visions can then be understood to arise from his psychoid body memory related to his traumatic conception and birth. The contemporary neuroscience which supports this view is outlined and a subsequent image schema explanation is presented. Clinically, the case material suggests that a pre-birth perspective needs to be explored in all analytic work. Other implications of Knox's image schema model are summarized.

  17. Imaging vascular function for early stage clinical trials using dynamic contrast-enhanced magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Leach, M.O.; Orton, M. [Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Cancer Research UK and EPSRC Cancer Imaging Centre, Sutton, Surrey (United Kingdom); Morgan, B. [Univ. of Leicester, College of Medicine, Biological Sciences and Psychology, Leicester (United Kingdom); Tofts, P.S. [Brighton and Sussex Medical School, Univ. of Sussex, Clinical Imaging Sciences Centre, Sussex (United Kingdom); Buckley, D.L. [University of Leeds, Division of Medical Physics, Leeds (United Kingdom); Huang, W. [Oregon Health and Science Univ., Advanced Imaging Research Centre, Portland, OR (United States); Horsfield, M.A. [Medical Physics Section, Leicester Royal Infirmary, Dept. of Cardiovascular Sciences, Leicester (United Kingdom); Chenevert, T.L. [Univ. of Michigan Health System, Ann Arbor, MI (United States); Collins, D.J. [Royal Marsden Hospital NHS Foundation Trust, Cancer Research UK and EPSRC Cancer Imaging Centre, Sutton, Surrey (United Kingdom); Jackson, A. [Univ. of Manchester, Wolfson Molecular Imaging Centre, Withington, Manchester, M20 3LJ (United Kingdom); Lomas, D. [Univ. of Cambridge, Dept. of Radiology, Cambridge (United Kingdom); Whitcher, B. [Unit 2 Greenways Business Park, Mango Solutions, Chippenham (United Kingdom); Clarke, L. [Cancer Imaging Program, Imaging Technology Development Branch, Rockville, MD (United States); Plummer, R. [Univ. of Newcastle Upon Tyne, The Medical School, Medical Oncology, Northern Inst. for Cancer Research, Newcastle Upon Tyne (United Kingdom); Judson, I. [Royal Marsden Hospital, Sutton, Surrey (United Kingdom); Jones, R. [Beatson West of Scotland Cancer Centre, Glasgow (United Kingdom); Alonzi, R. [Mount Vernon Cancer Centre, Northwood (United Kingdom); Brunner, T. [Gray Inst. for Radiation, Oncology and Biology, Oxford (United Kingdom); Koh, D.M. [Royal Marsden NHS Foundation Trust, Diagnostic Radiology, Sutton, Surrey (United Kingdom)] [and others


    Many therapeutic approaches to cancer affect the tumour vasculature, either indirectly or as a direct target. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has become an important means of investigating this action, both pre-clinically and in early stage clinical trials. For such trials, it is essential that the measurement process (i.e. image acquisition and analysis) can be performed effectively and with consistency among contributing centres. As the technique continues to develop in order to provide potential improvements in sensitivity and physiological relevance, there is considerable scope for between-centre variation in techniques. A workshop was convened by the Imaging Committee of the Experimental Cancer Medicine Centres (ECMC) to review the current status of DCE-MRI and to provide recommendations on how the technique can best be used for early stage trials. This review and the consequent recommendations are summarised here. (orig.)

  18. Clinical evaluation of irreversible image compression: analysis of chest imaging with computed radiography. (United States)

    Ishigaki, T; Sakuma, S; Ikeda, M; Itoh, Y; Suzuki, M; Iwai, S


    To implement a picture archiving and communication system, clinical evaluation of irreversible image compression with a newly developed modified two-dimensional discrete cosine transform (DCT) and bit-allocation technique was performed for chest images with computed radiography (CR). CR images were observed on a cathode-ray-tube monitor in a 1,024 X 1,536 matrix. One original and five reconstructed versions of the same images with compression ratios of 3:1, 6:1, 13:1, 19:1, and 31:1 were ranked according to quality. Test images with higher spatial frequency were ranked better than those with lower spatial frequency and the acceptable upper limit of the compression ratio was 19:1. In studies of receiver operating characteristics for scoring the presence or absence of nodules and linear shadows, the images with a compression ratio of 25:1 showed a statistical difference as compared with the other images with a compression ratio of 20:1 or less. Both studies show that plain CR chest images with a compression ratio of 10:1 are acceptable and, with use of an improved DCT technique, the upper limit of the compression ratio is 20:1.

  19. Simultaneous measurement of kidney function by dynamic contrast enhanced MRI and FITC-sinistrin clearance in rats at 3 tesla: initial results.

    Directory of Open Access Journals (Sweden)

    Frank G Zöllner

    Full Text Available Glomerular filtration rate (GFR is an essential parameter of kidney function which can be measured by dynamic contrast enhanced magnetic resonance imaging (MRI-GFR and transcutaneous approaches based on fluorescent tracer molecules (optical-GFR. In an initial study comparing both techniques in separate measurements on the same animal, the correlation of the obtained GFR was poor. The goal of this study was to investigate if a simultaneous measurement was feasible and if thereby, the discrepancies in MRI-GFR and optical-GFR could be reduced. For the experiments healthy and unilateral nephrectomised (UNX Sprague Dawley (SD rats were used. The miniaturized fluorescent sensor was fixed on the depilated back of an anesthetized rat. A bolus of 5 mg/100 g b.w. of FITC-sinistrin was intravenously injected. For dynamic contrast enhanced perfusion imaging (DCE-MRI a 3D time-resolved angiography with stochastic trajectories (TWIST sequence was used. By means of a one compartment model the excretion half-life (t1/2 of FITC-sinistrin was calculated and converted into GFR. GFR from DCE-MRI was calculated by fitting pixel-wise a two compartment renal filtration model. Mean cortical GFR and GFR by FITC-sinistrin were compared by Bland-Altman plots and pair-wise t-test. Results show that a simultaneous GFR measurement using both techniques is feasible. Mean optical-GFR was 4.34 ± 2.22 ml/min (healthy SD rats and 2.34 ± 0.90 ml/min (UNX rats whereas MRI-GFR was 2.10 ± 0.64 ml/min (SD rats and 1.17 ± 0.38 ml/min (UNX rats. Differences between healthy and UNX rats were significant (p<0.05 and almost equal percentage difference (46.1% and 44.3% in mean GFR were assessed with both techniques. Overall mean optical-GFR values were approximately twice as high compared to MRI-GFR values. However, compared to a previous study, our results showed a higher agreement. In conclusion, the possibility to use the transcutaneous method in MRI may have a huge impact in

  20. Hounsfield unit recovery in clinical cone beam CT images of the thorax acquired for image guided radiation therapy (United States)

    Slot Thing, Rune; Bernchou, Uffe; Mainegra-Hing, Ernesto; Hansen, Olfred; Brink, Carsten


    A comprehensive artefact correction method for clinical cone beam CT (CBCT) images acquired for image guided radiation therapy (IGRT) on a commercial system is presented. The method is demonstrated to reduce artefacts and recover CT-like Hounsfield units (HU) in reconstructed CBCT images of five lung cancer patients. Projection image based artefact corrections of image lag, detector scatter, body scatter and beam hardening are described and applied to CBCT images of five lung cancer patients. Image quality is evaluated through visual appearance of the reconstructed images, HU-correspondence with the planning CT images, and total volume HU error. Artefacts are reduced and CT-like HUs are recovered in the artefact corrected CBCT images. Visual inspection confirms that artefacts are indeed suppressed by the proposed method, and the HU root mean square difference between reconstructed CBCTs and the reference CT images are reduced by 31% when using the artefact corrections compared to the standard clinical CBCT reconstruction. A versatile artefact correction method for clinical CBCT images acquired for IGRT has been developed. HU values are recovered in the corrected CBCT images. The proposed method relies on post processing of clinical projection images, and does not require patient specific optimisation. It is thus a powerful tool for image quality improvement of large numbers of CBCT images.

  1. Toward an evaluation of an integrated clinical imaging system: identifying clinical benefits. (United States)

    Kaplan, B; Lundsgaarde, H P


    Integrated clinical imaging systems can provide the foundation for future computer-based patient record systems as recommended by the Institute of Medicine. However, documenting the benefits of such systems is difficult. This paper reports an evaluation of a clinical imaging system that is integrated with an on-line electronic patient record. The evaluation used interviews and observations to identify what physicians thought were the benefits of this system. Reported benefits may be classified into patient care benefits, educational benefits, and productivity and cost-reduction benefits Physicians said that the imaging system provided patient care benefits by: improving clinical communication and decision making, making care more patient-based, reducing the number of procedures and patient risks, and improving record keeping. Educational benefits they reported included: improving communication, providing broad "real" experience, and improving supervision. These benefits may be reflected in increased productivity and cost reduction by increasing time savings, reducing clerical work, improving morale, and reducing the costs of care. The approach described in this study was valuable in identifying potential benefits of a clinical information system. The findings point the way to realization of benefits for other systems, and, ultimately, for computer-based patient records.

  2. Intradiurnal fluctuations of off-resonance saturation effects in healthy human achilles tendons assessed with a 3D ultrashort echo time MRI sequence at 3 tesla

    Energy Technology Data Exchange (ETDEWEB)

    Grosse, U.; Syha, R.; Kessler, D.E.; Bongers, M.; Seith, F.; Nikolaou, K.; Springer, F. [University Hospital Tuebingen (Germany). Dept. of Diagnostic and Interventional Radiology; Partovi, S.; Robbin, M. [Case Western Reserve Univ., Cleveland, OH (United States). Dept. of Radiology; Schick, F. [University Hospital Tuebingen (Germany). Section on Experimental Radiology


    The purpose of this study was to evaluate whether gravitational interstitial fluid accumulation in healthy subjects has an impact on off-resonance saturation ratios (OSR) or the volume of the Achilles tendon after a prolonged time of reduced levels of physical activity. 7 healthy volunteers were repeatedly investigated on 3 consecutive days on a 3 T whole body MR scanner using an ultrashort echo time (UTE) imaging sequence with a Gaussian off-resonance saturation pulse at a frequency offset of 2000 Hz to calculate OSR values. For accurate volumetric quantification of the Achilles tendon, a newly developed contour detection snake algorithm was applied on high-resolution isotropic T2-weighted SPACE sequence datasets. Single-measure intraclass correlation coefficients (ICC) were calculated to estimate test-retest reliability. For OSR and tendon volume measurements on three consecutive days, excellent reproducibility could be achieved with ICC values above 0.96 and 0.97, respectively. Comparing the results of all three days, a statistically significant mean individual percentage decrease (-4.1 ± 1.5 %; p=0.001) of calculated tendon OSR values was found for the evening measurements. No statistically significant difference between tendon volumes in the morning and the evening could be detected (p=0.589). The results of this in-vivo study demonstrate a significant influence of gravitational interstitial fluid accumulation after reduced physical activity on OSR values in the Achilles tendon, but not on tendon volume. Taken together with the demonstrated excellent reproducibility, these findings are important for future studies investigating temporal changes of the Achilles tendon microstructure.

  3. Multimodality imaging in cranial blastomycosis, a great mimicker: Case-based illustration with review of clinical and imaging findings

    Directory of Open Access Journals (Sweden)

    Puneet S Kochar


    Full Text Available We describe the clinical, laboratory, and imaging data of three patients who are proven cases of blastomycosis with cranial involvement. In this review, we discuss the imaging features of cranial blastomycosis with relevant clinical case examples including computed tomography (CT, magnetic resonance imaging (MRI, and advanced MR imaging techniques like magnetic resonance spectroscopy (MRS and MR perfusion. Literature is reviewed for modern-day diagnosis and treatment of this fatal intracranial infection, if not diagnosed promptly and managed effectively.

  4. Left-sided gallbladder: Its clinical significance and imaging presentations

    Institute of Scientific and Technical Information of China (English)


    AIM: To assess the importance of preoperative diagnosis and presentation of left-sided gallbladder using ultrasound (US), CT and angiography.METHODS: Retrospective review of 1482 patients who underwent enhanced CT scanning was performed. Left-sided gallbladder was diagnosed if a right-sided ligamentum teres was present. The image presentations on US, CT and angiography were also reviewed.RESULTS: Left-sided gallbladder was diagnosed in nine patients. The associated abnormalities on CT imaging included portal vein anomalies, absence of umbilical portion of the portal vein in the left lobe of the liver,club-shaped portal vein in the right lobe of the liver, and difficulty in identifying segment Ⅳ. Angiography in six of nine patients demonstrated abnormal portal venous system (trifurcation type in four of six patients). The main hepatic arteries followed the portal veins in all six patients. The segment Ⅳ artery was identified in four of six patients using angiography, although segment Ⅳ was difficult to define on CT imaging. Hepatectomy was performed in three patients with concomitant liver tumor and the diagnosis of left-sided gallbladder was confirmed intraoperatively.CONCLUSION: Left-sided gallbladder is an important clinical entity in hepatectomy due to its associated portal venous and biliary anomalies. It should be considered in US, CT and angiography images that demonstrate no definite segment IV, absence of umbilical portion of the portal vein in the left lobe, and club-shaped right anterior portal vein.

  5. Functional imaging in oncology. Clinical applications. Vol. 2

    Energy Technology Data Exchange (ETDEWEB)

    Luna, Antonio [Case Western Reserve Univ., Cleveland, OH (United States). Dept. of Radiology; MRI Health Time Group, Jaen (Spain); Vilanova, Joan C. [Girona Univ. (Spain). Clinica Girona - Hospital Sta. Caterina; Hygino da Cruz, L. Celso Jr. (ed.) [CDPI and IRM, Rio de Janeiro (Brazil). Dept. of Radiology; Rossi, Santiago E. [Centro de Diagnostico, Buenos Aires (Argentina)


    Easy-to-read manual on new functional imaging techniques in oncology. Explains current clinical applications and outlines future avenues. Includes numerous high-quality illustrations to highlight the major teaching points. In the new era of functional and molecular imaging, both currently available imaging biomarkers and biomarkers under development are expected to lead to major changes in the management of oncological patients. This two-volume book is a practical manual on the various imaging techniques capable of delivering functional information on cancer, including diffusion MRI, perfusion CT and MRI, dual-energy CT, spectroscopy, dynamic contrast-enhanced ultrasonography, PET, and hybrid modalities. This second volume considers the applications and benefits of these techniques in a wide range of tumor types, including their role in diagnosis, prediction of treatment outcome, and early evaluation of treatment response. Each chapter addresses a specific malignancy and is written by one or more acclaimed experts. The lucid text is complemented by numerous high-quality illustrations that highlight key features and major teaching points.

  6. Schizencephaly: clinical and imaging features in 30 infantile cases. (United States)

    Denis, D; Chateil, J F; Brun, M; Brissaud, O; Lacombe, D; Fontan, D; Flurin, V; Pedespan, J


    Schizencephaly is an uncommon structural disorder of cerebral cortical development, characterized by congenital clefts spanning the cerebral hemispheres from the pial surface to the lateral ventricles and lined by cortical gray matter. Either an antenatal environmental incident or a genetic origin could be responsible for this lesion which occurs between the third and fourth month of gestation. We report the clinical and cranial imaging features of 30 children, of whom 15 had unilateral and 15 had bilateral lesions. Their ages at the time of the first presentation ranged from 1 month to 10 years. They were thoroughly studied from clinical, epileptical, imaging and electroencephalographic (EEG) viewpoints. Five patients were investigated by cranial computed tomography (CT), eight by cranial magnetic resonance (MR) imaging, and 17 by both methods. The clinical features consisted of mild hemiparesis in 17 cases (57%), 12/17 were related to a unilateral phenotype (80% of all unilateral forms) and 5/17 to a bilateral phenotype. A tetraparesis was present in nine cases, all of which were due to a bilateral cleft. Bilateral forms were significantly associated with tetraparesis, whereas unilateral forms were associated with hemiparesis. Mental retardation was observed in 17 cases (57%), and was observed significantly more often in bilateral clefts (80%). When both hemispheres are involved, an absence of reorganization of the brain function between the two hemispheres leads to severe mental deficits, in addition to the cerebral anomaly itself. Eleven patients had seizures (seven from unilateral and three from bilateral forms). The degree of malformation was not related to the severity of epilepsy. Migration disorders, such as dysplasia or heterotopia, were observed in 30% of cases and are also important etiopathogenetic factors. The septum pellucidum was absent in 13 cases (43%), with septo-optical dysplasia in two cases. Corpus callosum dysgenesis was noted in 30% of cases

  7. The economics of functional magnetic resonance imaging: clinical and research. (United States)

    Yousem, David M


    It is difficult to justify maintaining a clinical functional magnetic resonance imaging (fMRI) program based solely on revenue generation. The use of fMRI is, therefore, based mostly in patient care considerations, leading to better outcomes. The high costs of the top-of-the-line equipment, hardware, and software needed for state-of-the-art fMRI and the time commitment by multiple professionals are not adequately reimbursed at a representative rate by current payor schemes for the Current Procedure Terminology codes assigned.

  8. Cryogenic phased-array for high resolution magnetic resonance imaging (MRI); assessment of clinical and research applications (United States)

    Ip, Flora S.

    Magnetic Resonance (MR) imaging is one of the most powerful tools in diagnostic medicine for soft tissue imaging. Image acquisition techniques and hardware receivers are very important in achieving high contrast and high resolution MR images. An aim of this dissertation is to design single and multi-element room and cryogenic temperature arrays and make assessments of their signal-to-noise ratio (SNR) and SNR gain. In this dissertation, four sets of MR receiver coils are built. They are the receiver-only cryo-coils that are not commercially available. A tuning and matching circuit is attached to each coil. The tuning and matching circuits are simple; however, each device component has to operate at a high magnetic field and cryogenic temperature environment. Remote DC bias of the varactor controls the tuning and matching outside the scanner room. Active detuning of the resonator is done by two p-i-n junction (PIN) diodes. Cooling of the receiver is done by a customized liquid nitrogen cryostat. The first application is to build a 3-Tesla 2x1 horseshoe counter-rotating current (CRC) cryogenic array to image the tibia in a human body. With significant increase in SNR, the surface coil should deliver high contrast and resolution images that can show the trabecular bone and bone marrow structure. This structural image will be used to model the mechanical strength of the bone as well as bone density and chance of fracture. The planar CRC is a unique design of this surface array. The second application is to modify the coil design to 7-Tesla to study the growth of infant rhesus monkey eyes. Fast scan MR images of the infant monkey heads are taken for monitoring shapes of their eyeballs. The monkeys are induced with shortsightedness by eye lenses, and they are scanned periodically to get images of their eyeballs. The field-of-view (FOV) of these images is about five centimeters and the area of interest is two centimeters deep from the surface. Because of these reasons

  9. Unenhanced MR Imaging in adults with clinically suspected acute appendicitis

    DEFF Research Database (Denmark)

    Chabanova, Elizaveta; Balslev, Ingegerd; Achiam, Michael;


    PURPOSE: The purpose of the study was to evaluate unenhanced Magnetic Resonance Imaging (MRI) for the diagnosis of appendicitis or another surgery-requiring condition in an adult population scheduled for emergency appendectomy based on a clinical diagnosis of suspected acute appendicitis. MATERIALS...... radiologists and one surgeon independent of each other and compared with surgical and pathological records. RESULTS: According to the surgical and histopathological findings 30 of 48 patients (63%) had acute appendicitis. Of the remaining 18 patients, 4 patients had no reasons for the clinical symptoms and 14...... patients had other pathology. For the three reviewers the performance of MRI in the diagnosis of acute appendicitis showed the following sensitivity, specificity and accuracy ranges: 83-93%, 50-83% and 77-83%. Moderate (kappa=0.51) and fair (kappa=0.31) interobserver agreements in the MR diagnosis of acute...

  10. Bimelic Hirayama Disease: Clinical Dilemma Solved by Imaging

    Directory of Open Access Journals (Sweden)

    Shalabh Jain


    Full Text Available Hirayama disease (juvenile muscular atrophy of distal upper extremity is a cervical myelopathy predominantly affecting adolescent males. It is characterized by progressive muscular weakness and atrophy of unilateral or asymmetrically bilateral distal upper limbs. We report a case of an 18-year-male painter, who presented with gradually progressive, symmetrical bilateral weakness of hands and forearm for the last two years. On the basis of clinical examination, a provisional diagnosis of lower motor neuron type of symmetrical distal weakness due to heavy metal intoxication was kept. However, imaging studies helped in making a definitive diagnosis of Hirayama disease. The patient was advised cervical collar, and there was no progression in symptoms after six months of followup. Due to the rarity of bilateral symmetrical involvement in Hirayama disease, it remains obscured or unsuspected clinically, and MRI plays a pivotal role in diagnosis.

  11. MR imaging assessment of clinical problems in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Narvaez, Jose A.; Roca, Yolanda; Aguilera, Carlos [Department of CT and MR Imaging, Hospital Duran i Reynals, Universitaria de Bellvitge, Barcelona (Spain); Narvaez, Javier [Department of Medicine, Delfos Medical Center, Barcelona (Spain)


    Although MR imaging has been increasingly recognized as a useful tool in the diagnosis of early rheumatoid arthritis (RA) and in the assessment of disease activity, these applications have not yet been usually included in the routine management of this condition. Our goal is to review the current role of MRI in the everyday clinical management of patients with RA. The usefulness of MRI in the evaluation of articular and para-articular changes in specific locations, mainly the craniocervical region and the temporomandibular joint, are reviewed. Clinical problems derived from local extra-articular involvement, such as tenosynovitis, ''rice-bodies'' bursitis, and Baker's cyst rupture, are also described. Finally, we also review the value of MRI in evaluation of some complications of RA such as tendinous rupture, osteonecrosis, stress fracture, and septic arthritis/osteomyelitis. (orig.)

  12. Functional Imaging of Breast Tissue and Clinical Application

    Institute of Scientific and Technical Information of China (English)


    A novel approach to image hemoglobin concentration(ΔDhb) and oxygen saturation (ΔDoxy) of breast tissue is presented. The scenograph of dual-wavelength (760 and 850 nm) near infrared lights through breast tissue is acquired by high sensitive charge coupled device (CCD) camera. The evaluation criterion of the difference of ΔDhb and ΔDoxy between detected and referenced breast tissue can be obtained by a calculation formula without complicate caculation. This approach is applied to clinic detection in breast tissue. The ongoing clinical experiments indicate that malignant tumor usually exhibits characterize of "higher ΔDhb and lower ΔDoxy", while benign lesion often shows "lower ΔDhb and higher ΔDoxy" or other characters. So it is useful to assist the diagnosis of breast disease.

  13. Fast isotropic banding-free bSSFP imaging using 3D dynamically phase-cycled radial bSSFP (3D DYPR-SSFP)

    Energy Technology Data Exchange (ETDEWEB)

    Benkert, Thomas; Blaimer, Martin; Breuer, Felix A. [Research Center Magnetic Resonance Bavaria (MRB), Wuerzburg (Germany); Ehses, Philipp [Tuebingen Univ. (Germany). Dept. of Neuroimaging; Max Planck Institute for Biological Cybernetics, Tuebingen (Germany). High-Field MR Center; Jakob, Peter M. [Research Center Magnetic Resonance Bavaria (MRB), Wuerzburg (Germany); Wuerzburg Univ. (Germany). Dept. of Experimental Physics 5


    Aims: Dynamically phase-cycled radial balanced steady-state free precession (DYPR-SSFP) is a method for efficient banding artifact removal in bSSFP imaging. Based on a varying radiofrequency (RF) phase-increment in combination with a radial trajectory, DYPR-SSFP allows obtaining a banding-free image out of a single acquired k-space. The purpose of this work is to present an extension of this technique, enabling fast three-dimensional isotropic banding-free bSSFP imaging. Methods: While banding artifact removal with DYPR-SSFP relies on the applied dynamic phase-cycle, this aspect can lead to artifacts, at least when the number of acquired projections lies below a certain limit. However, by using a 3D radial trajectory with quasi-random view ordering for image acquisition, this problem is intrinsically solved, enabling 3D DYPR-SSFP imaging at or even below the Nyquist criterion. The approach is validated for brain and knee imaging at 3 Tesla. Results: Volumetric, banding-free images were obtained in clinically acceptable scan times with an isotropic resolution up to 0.56 mm. Conclusion: The combination of DYPR-SSFP with a 3D radial trajectory allows banding-free isotropic volumetric bSSFP imaging with no expense of scan time. Therefore, this is a promising candidate for clinical applications such as imaging of cranial nerves or articular cartilage.

  14. Sinusitis and intracranial sepsis: the CT imaging and clinical presentation

    Energy Technology Data Exchange (ETDEWEB)

    Saxton, V.J. [Dept. of Radiology, Royal Children`s Hospital, Melbourne (Australia); Boldt, D.W. [Dept. of Radiology, Royal Children`s Hospital, Melbourne (Australia); Shield, L.K. [Dept. of Neurology, Royal Children`s Hospital, Melbourne (Australia)


    The CT imaging and clinical presentation in 14 children with coexistent intracranial sepsis and sinusitis were reviewed. A routine CT head scan (10-mm thick semi-axial slices through the cranium done before and after intravenous contrast medium administration) was found to be an inadequate initial investigation as the intracranial collection was missed in four patients and the abnormal sinuses not shown in six. In half the children the dagnosis of sinusitis was unsuspected at the time of admission. The dominant clinical features were fever, intense headache and facial swelling in early adolescent males. In this clinical setting we recommend: (1) The routine scan is extended through the frontal and ethmoidal sinuses and photographed at a window level and width showing both bone detail and air/soft tissue interfaces; (2) direct coronal projections are performed through the anterior cranial fossa if no collection is seen on the routine study; (3) an early repeat scan within 48 h if the initial study shows no intracranial pathology but the fronto-ethomoidal sinuses are abnormal and there is a high clinical supicion of intracranial sepsis; and (4) in the presence of intracranial sepsis the vault is viewed at bone window settings to exclude cranial osteomyelitis. (orig.)

  15. Nanoparticles for Biomedical Imaging: Fundamentals of Clinical Translation

    Directory of Open Access Journals (Sweden)

    Hak Soo Choi


    Full Text Available Because of their large size compared to small molecules and their multifunctionality, nanoparticles (NPs hold promise as biomedical imaging, diagnostic, and theragnostic agents. However, the key to their success hinges on a detailed understanding of their behavior after administration into the body. NP biodistribution, target binding, and clearance are complex functions of their physicochemical properties in serum, which include hydrodynamic diameter, solubility, stability, shape and flexibility, surface charge, composition, and formulation. Moreover, many materials used to construct NPs have real or potential toxicity or may interfere with other medical tests. In this review, we discuss the design considerations that mediate NP behavior in the body and the fundamental principles that govern clinical translation. By analyzing those nanomaterials that have already received regulatory approval, most of which are actually therapeutic agents, we attempt to predict which types of NPs hold potential as diagnostic agents for biomedical imaging. Finally, using quantum dots as an example, we provide a framework for deciding whether an NP-based agent is the best choice for a particular clinical application.

  16. Advances in functional magnetic resonance imaging: technology and clinical applications. (United States)

    Dickerson, Bradford C


    Functional MRI (fMRI) is a valuable method for use by clinical investigators to study task-related brain activation in patients with neurological or neuropsychiatric illness. Despite the relative infancy of the field, the rapid adoption of this functional neuroimaging technology has resulted from, among other factors, its ready availability, its relatively high spatial and temporal resolution, and its safety as a noninvasive imaging tool that enables multiple repeated scans over the course of a longitudinal study, and thus may lend itself well as a measure in clinical drug trials. Investigators have used fMRI to identify abnormal functional brain activity during task performance in a variety of patient populations, including those with neurodegenerative, demyelinating, cerebrovascular, and other neurological disorders that highlight the potential utility of fMRI in both basic and clinical spheres of research. In addition, fMRI studies reveal processes related to neuroplasticity, including compensatory hyperactivation, which may be a universally-occurring, adaptive neural response to insult. Functional MRI is being used to study the modulatory effects of genetic risk factors for neurological disease on brain activation; it is being applied to differential diagnosis, as a predictive biomarker of disease course, and as a means to identify neural correlates of neurotherapeutic interventions. Technological advances are rapidly occurring that should provide new applications for fMRI, including improved spatial resolution, which promises to reveal novel insights into the function of fine-scale neural circuitry of the human brain in health and disease.

  17. Clinical application of functional magnetic resonance imaging in China

    Institute of Scientific and Technical Information of China (English)

    MA Lin


    @@ Functional magnetic resonance imaging (fMRI)has been widely used in basic research in the past decade, and more clinically in recent years.Unlike conventional MRI that demonstrates the anatomy and morphology of the brain, fMRI provides the functional information of the brain, including neuronal activation, perfusion, diffusion, metabolism,and fiber connection. Since the publication of the pioneer study by Ogawa et al1 in 1990, blood oxygenation level dependent (BOLD) technique has been adopted by neuroscientists and psychologists in research into the mechanisms of motion, vision,hearing, language, memory, and functions of the brain. Soon after, clinical studies with BOLD technique were conducted in some fields like surgery (surgical planning). In China, however, basic and clinical studies on fMRI in the early years were limited by the shortage of funding, difficulty in integrating personnel of different disciplines from different institutions, and long-term use of MR scanners. In recent years, the studies on fMRI in this country have been flourishing as the conditions are greatly improved, and the number of published papers has increased because more and more radiologists and clinicians are involved.

  18. Hemicrania Continua: Functional Imaging and Clinical Features With Diagnostic Implications. (United States)

    Sahler, Kristen


    This review focuses on summarizing 2 pivotal articles in the clinical and pathophysiologic understanding of hemicrania continua (HC). The first article, a functional imaging project, identifies both the dorsal rostral pons (a region associated with the generation of migraines) and the posterior hypothalamus (a region associated with the generation of cluster and short-lasting unilateral neuralgiform headache with conjunctival injection and tearing [SUNCT]) as active during HC. The second article is a summary of the clinical features seen in a prospective cohort of HC patients that carry significant diagnostic implications. In particular, they identify a wider range of autonomic signs than what is currently included in the International Headache Society criteria (including an absence of autonomic signs in a small percentage of patients), a high frequency of migrainous features, and the presence of aggravation and/or restlessness during attacks. Wide variations in exacerbation length, frequency, pain description, and pain location (including side-switching pain) are also noted. Thus, a case is made for widening and modifying the clinical diagnostic criteria used to identify patients with HC.

  19. Lumbar spinal imaging in radicular pain and related conditions. Understanding diagnostic images in a clinical context

    Energy Technology Data Exchange (ETDEWEB)

    Wilmink, Jan T. [University Hospital Maastricht (Netherlands). Dept. Radiology


    There is general agreement that lumbosacral nerve root compression is a prime factor in the pathogenesis of sciatica and neurogenic claudication, although humoral and vascular factors certainly play a role as well. This book focuses on imaging of the various ways in which nerve root compression can come about, and assessing which anatomic features are reliably associated with the occurrence of radicular pain, as opposed to morphologic findings which are probably coincidental. After a discussion of the nature of radicular pain and related symptoms, spinal imaging techniques and options are reviewed, with emphasis on the role of MR myelography in assessing the condition of the intradural nerve roots. A chapter on normal topographic, sectional, and functional (dynamic) radiologic anatomy is followed by a presentation on pathologic anatomy, addressing the various mechanisms of nerve root compression. In the chapter on pre- and postoperative imaging, features which may help to predict the evolution of the symptoms are discussed, with an eye to selecting candidates for surgical treatment. This is followed by a discussion of the role and limitations of imaging studies in various adverse postoperative conditions. In illustrations involving patient studies, imaging features are linked where possible to the clinical symptoms and history of the individuals involved. (orig.)

  20. Juvenile idiopathic arthritis: clinically relevant imaging in diagnosis and monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Southwood, Tauny [Birmingham Children' s Hospital NHS Foundation Trust, Department of Rheumatology, Birmingham (United Kingdom)


    The role of plain radiographs in monitoring the disease process in JIA is being increasingly superseded by MRI. The use of ultrasound by clinicians is contentious, but has the potential to corroborate and supplement the clinical impression of individual joint inflammation and it can be very useful for localising intra-articular treatment at the bedside. There are exciting developments in MRS technology which may eventually allow in vivo evaluation of the acute inflammatory process, measurement of early responses to treatment and detection of residual inflammation. The aim of this article is to describe a clinician's view of the current role of imaging in the diagnosis and monitoring of JIA. (orig.)

  1. SLAP lesions: Anatomy, clinical presentation, MR imaging diagnosis and characterization

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Debra [University of California San Diego, Department of Radiology, 200 W. Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States); MedRay Imaging and Fraser Health Authority, Vancouver, BC (Canada)], E-mail:; Mohana-Borges, Aurea; Borso, Maya; Chung, Christine B. [University of California San Diego, Department of Radiology, 200 W. Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States)


    ABSTRACT: Superior labral anterior posterior (SLAP) tears are an abnormality of the superior labrum usually centered on the attachment of the long head of the biceps tendon. Tears are commonly caused by repetitive overhead motion or fall on an outstretched arm. SLAP lesions can lead to shoulder pain and instability. Clinical diagnosis is difficult thus imaging plays a key diagnostic role. The normal anatomic variability of the capsulolabral complex can make SLAP lesions a diagnostic challenge. Concurrent shoulder injuries are often present including rotator cuff tears, cystic changes or marrow edema in the humeral head, capsular laxity, Hill-Sachs or Bankart lesion. The relevant anatomy, capsulolabral anatomic variants, primary and secondary findings of SLAP tears including MR arthrography findings, types of SLAP lesions and a practical approach to labral lesions are reviewed.

  2. Clinical types of spinocerebellar degeneration and evaluation with MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kojima, Shigeyuki (Chiba Univ. (Japan). School of Medicine)


    Eighty one patients with the clinical diagnosis of non-hereditary spinocerebellar degeneration were examined by magnetic resonance imaging (MRI). The MRI findings were subdivided into non-cerebellar atrophy, cerebellar atrophy without and with apparent enlargement of the fourth ventricle as a result of atrophy of the middle or superior cerebellar peduncles. The first pattern of non-cerebellar atrophy included ataxias such as Friendreich's ataxia and Machado-Joseph disease (MJD; type II). In the patients with MJD, atrophy of the brainstem was frequently recognized. The second pattern largely included late cortical cerebellar atrophy and hereditary ataxia of Holmes type. The third pattern was subdivided further into atrophies of the middle and superior cerebellar peduncles. The pattern of the former included olivo-ponto-cerebellar atrophy (OPCA) and hereditary ataxia of Menzel type, and the pattern of the latter included MJD and dentato-rubro-pallido-luysian atrophy (DRPLA). In the patients with OPCA and hereditary ataxia of Menzel type, increased signal intensity on T2-weighted image was always observed in the transverese pontine fibers, middle cerebellar peduncles. In several patients with MJD and DRPLA, atrophy of both cerebellar peduncles was demonstrated, but abnormal signal intensity was not observed in the pontocerebellar areas. (author).

  3. Imaging tissue hypoxia: clinical and pre-clinical experience with {sup 123}IAZA

    Energy Technology Data Exchange (ETDEWEB)

    Wiebe, L.I. [University of Alberta, Edmonton (Canada). Noujaim Institute for Pharmaceutical Oncology Research, Faculty of Pharmacy and Pharmaceutical Sciences


    The molecular mechanisms that underline the selective binding of iodazomycin arabinoside, IAZA, and related nitromidazoles are reviewed as a basis for interpretation of preclinical and clinical data for hypoxic binding of radioiodinated IAZA. Clinical data are presented for {sup 123}IAZA uptake in a number of pathologies including metastatic tumours, peripheral vascular disease in diabetes, muscle stress and rheumatoid arthritis. The results of studies to determine the influence of tumour type on uptake of {sup 123} I-IAZA in patients with a variety of deep-seated solid tumours will be presented. Correlations of hypoxia-dependent binding with {sup 99m}Tc-HMPAO perfusion images will be reviewed and early correlations of uptake to treatment response in cancer will be presented. Unusual features of {sup 123}I-IAZA biodistribution will also be discussed together with detailed pharmacokinetic and radiation dosimetry data for `2{sup 123}I- IAZA in normal volunteers 27 refs., 1 fig.

  4. Primary epiploic appendagitis: Clinic and radiologic imaging findings

    Directory of Open Access Journals (Sweden)

    Mustafa Koplay


    Full Text Available Introduction: Primary epiploic appendagitis (PEA is arare and self-limiting disease that can mimicking acuteapendicitis and diverticulitis because of the clinical symptoms.The present retrospective study was discussed toclinical and radiologic characteristics of PEA.Methods: We reviewed the clinical, laboratory and computedtomography (CT findings of 10 patients with PEAbetween August 2010 and December 2012.Results: Ten patients (1 female and 9 males were diagnosedwith PEA. The average age was 37.1 (15-63years. Abdominal pain was localized to the right (2 cases,20% or left (7 cases, 70% lower quadrants and generalized(1 cases, 10%. All patients were afebrile. Only twopatients showed leukocytosis. There were gastrointestinalsymptoms such as nausea (3 patients and vomiting(1patient. In all cases, a pericolic fatty mass with a hyperattenuated ring was observed on CT. All of the patientswere treated symptomatic.Conlusion: In patients have atypical symptoms and laboratoryvalues with abdominal pain (especially left lowerabdominal pain, PEA should be considered in differentialdiagnosis. For correct diagnosis and avoid unnecessarysurgery, CT must be used in diagnosis because imagingfindings characteristic of the disease.Key words: Primary epiploic appendagitis, imaging, CT

  5. Joint Probability Models of Radiology Images and Clinical Annotations (United States)

    Arnold, Corey Wells


    Radiology data, in the form of images and reports, is growing at a high rate due to the introduction of new imaging modalities, new uses of existing modalities, and the growing importance of objective image information in the diagnosis and treatment of patients. This increase has resulted in an enormous set of image data that is richly annotated…

  6. Unenhanced MR Imaging in adults with clinically suspected acute appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Chabanova, Elizaveta, E-mail: [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Balslev, Ingegerd, E-mail: [Department of Pathology, Copenhagen University Hospital at Herlev (Denmark); Achiam, Michael, E-mail: [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Nielsen, Yousef W., E-mail: [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Adamsen, Sven, E-mail: [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Gocht-Jensen, Peter, E-mail: [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Brisling, Steffen K., E-mail: [Department of Gastrointestinal Surgery, Copenhagen University Hospital at Herlev (Denmark); Logager, Vibeke B., E-mail: [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Thomsen, Henrik S., E-mail: [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark)


    Purpose: The purpose of the study was to evaluate unenhanced Magnetic Resonance Imaging (MRI) for the diagnosis of appendicitis or another surgery-requiring condition in an adult population scheduled for emergency appendectomy based on a clinical diagnosis of suspected acute appendicitis. Materials and methods: The prospective study included 48 consecutive patients (29 female, 19 male, 18-70 years old, mean age = 37.1 years). MRI examination was designed to be comfortable and fast; no contrast was administered. The sequences were performed during quiet respiration. The MRI findings were reviewed by two radiologists and one surgeon independent of each other and compared with surgical and pathological records. Results: According to the surgical and histopathological findings 30 of 48 patients (63%) had acute appendicitis. Of the remaining 18 patients, 4 patients had no reasons for the clinical symptoms and 14 patients had other pathology. For the three reviewers the performance of MRI in the diagnosis of acute appendicitis showed the following sensitivity, specificity and accuracy ranges: 83-93%, 50-83% and 77-83%. Moderate ({kappa} = 0.51) and fair ({kappa} = 0.31) interobserver agreements in the MR diagnosis of acute appendicitis were found between the reviewers. Sensitivity, specificity and accuracy values for overall performance of MRI in detecting pelvic abnormalities were 100%, 75% (3 of 4 healthy patients were identified by MRI) and 98%, respectively. Conclusion: Unenhanced fast MRI is feasible as an additional fast screening before the appendectomy. It may prevent unnecessary surgeries. The fast MRI examination can be adequately performed on an MRI unit of broad range of field strengths.

  7. Hounsfield unit recovery in clinical cone beam CT images of the thorax acquired for image guided radiation therapy

    DEFF Research Database (Denmark)

    Thing, Rune Slot; Bernchou, Uffe; Mainegra-Hing, Ernesto;


    A comprehensive artefact correction method for clinical cone beam CT (CBCT) images acquired for image guided radiation therapy (IGRT) on a commercial system is presented. The method is demonstrated to reduce artefacts and recover CT-like Hounsfield units (HU) in reconstructed CBCT images of five......-correspondence with the planning CT images, and total volume HU error. Artefacts are reduced and CT-like HUs are recovered in the artefact corrected CBCT images. Visual inspection confirms that artefacts are indeed suppressed by the proposed method, and the HU root mean square difference between reconstructed CBCTs...

  8. Diffusion weighted magnetic resonance imaging of the breast: protocol optimization, interpretation, and clinical applications. (United States)

    Partridge, Savannah C; McDonald, Elizabeth S


    Diffusion-weighted magnetic resonance (MR) imaging (DWI) has shown promise for improving the positive predictive value of breast MR imaging for detection of breast cancer, evaluating tumor response to neoadjuvant chemotherapy, and as a noncontrast alternative to MR imaging in screening for breast cancer. However, data quality varies widely. Before implementing DWI into clinical practice, one must understand the pertinent technical considerations and current evidence regarding clinical applications of breast DWI. This article provides an overview of basic principles of DWI, optimization of breast DWI protocols, imaging features of benign and malignant breast lesions, promising clinical applications, and potential future directions.

  9. Unique roles of SPET brain imaging in clinical and research studies. Lessons from Parkinson's disease research. (United States)

    Seibyl, J; Jennings, D; Tabamo, R; Marek, K


    The increasing availability of PET imaging in nuclear medicine expands the armamentarium of clinical and research tools for improving diagnosis and treatment of neuropsychiatric disorders. Nonetheless, the role of SPECT imaging remains critical to both research and clinical practice. The development of rational strategies for guiding the selection of imaging modalities flows from primarily the nature of the clinical or research question and the availability of appropriate radiopharmaceuticals. There has been extensive SPECT and PET work in Parkinson's disease (PD) which highlights the value of both these scintigraphic modalities. Three main areas of interest in PD include imaging for improving diagnostic accuracy, for monitoring the progression of disease, and for assessing the therapeutic efficacy of drugs with neuroprotective potential. The demands of the clinical or research question posed to imaging dictates the selection of radiotracer and imaging modality. Diagnosis of PD represents the easiest challenge with many imaging biomarkers showing high sensitivity for detecting abnormal reduction of dopaminergic function based on qualitative review of images. On the other hand, using imaging to evaluate treatments which purportedly slow the rate of disease progression, indicated by the reduction in the rate of loss in a quantitative imaging signal in patients studied over time, represents the most rigorous requirement of the imaging measure. In each of these applications presynaptic markers of dopaminergic function using SPECT and PET have been extremely valuable. Review of neuroimaging studies of PD provides a useful example of optimized approaches to clinical and research studies in neuropsychiatric disorders.

  10. Image-guided drug delivery: preclinical applications and clinical translation

    NARCIS (Netherlands)

    Ojha, Tarun; Rizzo, Larissa; Storm, Gert; Kiessling, Fabian; Lammers, Twan


    Image-guided drug delivery refers to the combination of drug targeting and imaging. Preclinically, image-guided drug delivery can be used for several different purposes, including for monitoring biodistribution, target site accumulation, off-target localization, drug release and drug efficacy. Clini

  11. Image-guided drug delivery : Preclinical applications and clinical translation

    NARCIS (Netherlands)

    Ojha, Tarun; Rizzo, Larissa; Storm, G; Kiessling, Fabian; Lammers, Twan


    Image-guided drug delivery refers to the combination of drug targeting and imaging. Preclinically, image-guided drug delivery can be used for several different purposes, including for monitoring biodistribution, target site accumulation, off-target localization, drug release and drug efficacy. Clini

  12. Image artifacts from MR-based attenuation correction in clinical, whole-body PET/MRI

    DEFF Research Database (Denmark)

    Keller, Sune H; Holm, Søren; Hansen, Adam E;


    Integrated whole-body PET/MRI tomographs have become available. PET/MR imaging has the potential to supplement, or even replace combined PET/CT imaging in selected clinical indications. However, this is true only if methodological pitfalls and image artifacts arising from novel MR-based attenuation...

  13. High frame rate photoacoustic imaging at 7000 frames per second using clinical ultrasound system. (United States)

    Sivasubramanian, Kathyayini; Pramanik, Manojit


    Photoacoustic tomography, a hybrid imaging modality combining optical and ultrasound imaging, is gaining attention in the field of medical imaging. Typically, a Q-switched Nd:YAG laser is used to excite the tissue and generate photoacoustic signals. But, such photoacoustic imaging systems are difficult to translate into clinical applications owing to their high cost, bulky size often requiring an optical table to house such lasers. Moreover, the low pulse repetition rate of few tens of hertz prevents them from being used in high frame rate photoacoustic imaging. In this work, we have demonstrated up to 7000 Hz photoacoustic imaging (B-mode) and measured the flow rate of a fast moving object. We used a ~140 nanosecond pulsed laser diode as an excitation source and a clinical ultrasound imaging system to capture and display the photoacoustic images. The excitation laser is ~803 nm in wavelength with ~1.4 mJ energy per pulse. So far, the reported 2-dimensional photoacoustic B-scan imaging is only a few tens of frames per second using a clinical ultrasound system. Therefore, this is the first report on 2-dimensional photoacoustic B-scan imaging with 7000 frames per second. We have demonstrated phantom imaging to view and measure the flow rate of ink solution inside a tube. This fast photoacoustic imaging can be useful for various clinical applications including cardiac related problems, where the blood flow rate is quite high, or other dynamic studies.

  14. 骨和软组织肿瘤的3.0T磁共振磷谱变化研究%Changes of 3-tesla 31P-MR spectroscopy of bone and soft tissue tumors

    Institute of Scientific and Technical Information of China (English)

    齐滋华; 李传福; 马祥兴; 李振峰; 张凯; 于德新


    Objective To study the characteristic changes of 31P-MR spectroscopy of bone and soft tissue tumors. Methods 41 patients were examined by phosphorus surface coil of 3 tesla MR machine, including 18 benign tumor foci and 28 malignant foci, and adjacent normal muscles. The areas under the peaks of various metabolites in the spectra were measured, including phosphomonoester(PME), inorganic phosphours (Pi), phosphodiester(PDE), phosphocreatine ( Pcr ), adenosine triphosphate (ATP) γ, α, β. The ratios of the metabolites to β-ATP, NTP and Pcr were calculated. Intracellular pH was calculated according to the chemical shift change of Pi relative to Per. Results The ratios of Pcr/PME and PME/NTP in benign and malignant tumor groups were significantly different from those of the normal group ( P < 0.05). Between benign and malignant tumor groups, the ratios of PME/β-ATP and PME/NTP were significantly different (P < 0.05). Conclusion Pcr/PME and PME/NTP are potential diagnostic indexes of bone and soft tissue tumors. PME/β-ATP and PME/NTP are potential indexes of differential diagnosis of bone and soft tissue tumors.%目的 探讨骨和软组织肿瘤磁共振磷谱(31P-MRS)的变化特点.方法 对41例经病理证实的骨和软组织肿瘤患者的18个良性肿瘤病灶、28个恶性肿瘤病灶及其相邻部位正常肌肉组织,应用3.0T MR机进行31P-MRS分析,测量波谱中磷酸单酯(PME)、无机磷(Pi)、磷酸二酯(PDE)、磷酸肌酸(Pcr)、三磷酸腺苷γ-峰(γ-ATP)、α-峰(α-ATP)和β-峰(β-ATP)的峰下面积.分别以β-ATP、三磷酸核苷(NTP)和Pcr为参照,计算各代谢产物的相对比值.根据Pi相对于Pcr化学位移的变化计算细胞内pH值.结果 良、恶性肿瘤组中Pcr/PME、PME/NTP与正常对照组比较,差异均有统计学意义(P<0.05).良、恶性肿瘤组中PME/β-ATP与PME/NTP比较,差异有统计学意义(P<0.05).结论 Pcr/PME和PME/NTP是诊断骨和软组织肿瘤的潜在指标,PME/β-ATP和PME/NTP是

  15. Modern dental imaging: a review of the current technology and clinical applications in dental practice

    Energy Technology Data Exchange (ETDEWEB)

    Vandenberghe, Bart; Jacobs, Reinhilde [Katholieke Universiteit Leuven, Oral Imaging Centre, Faculty of Medicine, School of Dentistry, Oral Pathology and Maxillofacial Surgery, Leuven (Belgium); Bosmans, Hilde [Katholieke Universiteit Leuven, Radiology Section, Department of Medical Diagnostic Sciences, Leuven (Belgium)


    A review of modern imaging techniques commonly used in dental practice and their clinical applications is presented. The current dental examinations consist of intraoral imaging with digital indirect and direct receptors, while extraoral imaging is divided into traditional tomographic/panoramic imaging and the more recently introduced cone beam computed tomography. Applications, limitations and current trends of these dental ''in-office'' radiographic techniques are discussed. (orig.)

  16. The Noise Clinic: a Blind Image Denoising Algorithm

    Directory of Open Access Journals (Sweden)

    Marc Lebrun


    Full Text Available This paper describes the complete implementation of a blind image algorithm, that takes any digital image as input. In a first step the algorithm estimates a Signal and Frequency Dependent (SFD noise model. In a second step, the image is denoised by a multiscale adaptation of the Non-local Bayes denoising method. We focus here on a careful analysis of the denoising step and present a detailed discussion of the influence of its parameters. Extensive commented tests of the blind denoising algorithm are presented, on real JPEG images and scans of old photographs.

  17. Quantitative comparison of OSEM and penalized likelihood image reconstruction using relative difference penalties for clinical PET. (United States)

    Ahn, Sangtae; Ross, Steven G; Asma, Evren; Miao, Jun; Jin, Xiao; Cheng, Lishui; Wollenweber, Scott D; Manjeshwar, Ravindra M


    Ordered subset expectation maximization (OSEM) is the most widely used algorithm for clinical PET image reconstruction. OSEM is usually stopped early and post-filtered to control image noise and does not necessarily achieve optimal quantitation accuracy. As an alternative to OSEM, we have recently implemented a penalized likelihood (PL) image reconstruction algorithm for clinical PET using the relative difference penalty with the aim of improving quantitation accuracy without compromising visual image quality. Preliminary clinical studies have demonstrated visual image quality including lesion conspicuity in images reconstructed by the PL algorithm is better than or at least as good as that in OSEM images. In this paper we evaluate lesion quantitation accuracy of the PL algorithm with the relative difference penalty compared to OSEM by using various data sets including phantom data acquired with an anthropomorphic torso phantom, an extended oval phantom and the NEMA image quality phantom; clinical data; and hybrid clinical data generated by adding simulated lesion data to clinical data. We focus on mean standardized uptake values and compare them for PL and OSEM using both time-of-flight (TOF) and non-TOF data. The results demonstrate improvements of PL in lesion quantitation accuracy compared to OSEM with a particular improvement in cold background regions such as lungs.

  18. Retrieving clinically relevant diabetic retinopathy images using a multi-class multiple-instance framework (United States)

    Chandakkar, Parag S.; Venkatesan, Ragav; Li, Baoxin


    Diabetic retinopathy (DR) is a vision-threatening complication from diabetes mellitus, a medical condition that is rising globally. Unfortunately, many patients are unaware of this complication because of absence of symptoms. Regular screening of DR is necessary to detect the condition for timely treatment. Content-based image retrieval, using archived and diagnosed fundus (retinal) camera DR images can improve screening efficiency of DR. This content-based image retrieval study focuses on two DR clinical findings, microaneurysm and neovascularization, which are clinical signs of non-proliferative and proliferative diabetic retinopathy. The authors propose a multi-class multiple-instance image retrieval framework which deploys a modified color correlogram and statistics of steerable Gaussian Filter responses, for retrieving clinically relevant images from a database of DR fundus image database.

  19. Evaluation of clinical image processing algorithms used in digital mammography. (United States)

    Zanca, Federica; Jacobs, Jurgen; Van Ongeval, Chantal; Claus, Filip; Celis, Valerie; Geniets, Catherine; Provost, Veerle; Pauwels, Herman; Marchal, Guy; Bosmans, Hilde


    Screening is the only proven approach to reduce the mortality of breast cancer, but significant numbers of breast cancers remain undetected even when all quality assurance guidelines are implemented. With the increasing adoption of digital mammography systems, image processing may be a key factor in the imaging chain. Although to our knowledge statistically significant effects of manufacturer-recommended image processings have not been previously demonstrated, the subjective experience of our radiologists, that the apparent image quality can vary considerably between different algorithms, motivated this study. This article addresses the impact of five such algorithms on the detection of clusters of microcalcifications. A database of unprocessed (raw) images of 200 normal digital mammograms, acquired with the Siemens Novation DR, was collected retrospectively. Realistic simulated microcalcification clusters were inserted in half of the unprocessed images. All unprocessed images were subsequently processed with five manufacturer-recommended image processing algorithms (Agfa Musica 1, IMS Raffaello Mammo 1.2, Sectra Mamea AB Sigmoid, Siemens OPVIEW v2, and Siemens OPVIEW v1). Four breast imaging radiologists were asked to locate and score the clusters in each image on a five point rating scale. The free-response data were analyzed by the jackknife free-response receiver operating characteristic (JAFROC) method and, for comparison, also with the receiver operating characteristic (ROC) method. JAFROC analysis revealed highly significant differences between the image processings (F = 8.51, p < 0.0001), suggesting that image processing strongly impacts the detectability of clusters. Siemens OPVIEW2 and Siemens OPVIEW1 yielded the highest and lowest performances, respectively. ROC analysis of the data also revealed significant differences between the processing but at lower significance (F = 3.47, p = 0.0305) than JAFROC. Both statistical analysis methods revealed that the

  20. Fuzzy Logic Based Edge Detection in Smooth and Noisy Clinical Images.

    Directory of Open Access Journals (Sweden)

    Izhar Haq

    Full Text Available Edge detection has beneficial applications in the fields such as machine vision, pattern recognition and biomedical imaging etc. Edge detection highlights high frequency components in the image. Edge detection is a challenging task. It becomes more arduous when it comes to noisy images. This study focuses on fuzzy logic based edge detection in smooth and noisy clinical images. The proposed method (in noisy images employs a 3 × 3 mask guided by fuzzy rule set. Moreover, in case of smooth clinical images, an extra mask of contrast adjustment is integrated with edge detection mask to intensify the smooth images. The developed method was tested on noise-free, smooth and noisy images. The results were compared with other established edge detection techniques like Sobel, Prewitt, Laplacian of Gaussian (LOG, Roberts and Canny. When the developed edge detection technique was applied to a smooth clinical image of size 270 × 290 pixels having 24 dB 'salt and pepper' noise, it detected very few (22 false edge pixels, compared to Sobel (1931, Prewitt (2741, LOG (3102, Roberts (1451 and Canny (1045 false edge pixels. Therefore it is evident that the developed method offers improved solution to the edge detection problem in smooth and noisy clinical images.

  1. Fuzzy Logic Based Edge Detection in Smooth and Noisy Clinical Images. (United States)

    Haq, Izhar; Anwar, Shahzad; Shah, Kamran; Khan, Muhammad Tahir; Shah, Shaukat Ali


    Edge detection has beneficial applications in the fields such as machine vision, pattern recognition and biomedical imaging etc. Edge detection highlights high frequency components in the image. Edge detection is a challenging task. It becomes more arduous when it comes to noisy images. This study focuses on fuzzy logic based edge detection in smooth and noisy clinical images. The proposed method (in noisy images) employs a 3 × 3 mask guided by fuzzy rule set. Moreover, in case of smooth clinical images, an extra mask of contrast adjustment is integrated with edge detection mask to intensify the smooth images. The developed method was tested on noise-free, smooth and noisy images. The results were compared with other established edge detection techniques like Sobel, Prewitt, Laplacian of Gaussian (LOG), Roberts and Canny. When the developed edge detection technique was applied to a smooth clinical image of size 270 × 290 pixels having 24 dB 'salt and pepper' noise, it detected very few (22) false edge pixels, compared to Sobel (1931), Prewitt (2741), LOG (3102), Roberts (1451) and Canny (1045) false edge pixels. Therefore it is evident that the developed method offers improved solution to the edge detection problem in smooth and noisy clinical images.

  2. CT of jejunal diverticulitis: imaging findings, differential diagnosis, and clinical management

    Energy Technology Data Exchange (ETDEWEB)

    Macari, M.; Faust, M.; Liang, H.; Pachter, H.L


    Aim: To describe the imaging findings of jejunal diverticulitis as depicted at contrast-enhanced computed tomography (CT) and review the differential diagnosis and clinical management. Materials and Methods: CT and pathology databases were searched for the diagnosis of jejunal diverticulitis. Three cases were identified and the imaging and clinical findings correlated. Results: Jejunal diverticulitis presents as a focal inflammatory mass involving the proximal small bowel. A trial of medical management with antibiotics may be attempted. Surgical resection may be required if medical management is unsuccessful. Conclusion: The imaging findings at MDCT may allow a specific diagnosis of jejunal diverticulitis to be considered and may affect the clinical management of the patient.

  3. Recent advances in computational methods and clinical applications for spine imaging

    CERN Document Server

    Glocker, Ben; Klinder, Tobias; Li, Shuo


    This book contains the full papers presented at the MICCAI 2014 workshop on Computational Methods and Clinical Applications for Spine Imaging. The workshop brought together scientists and clinicians in the field of computational spine imaging. The chapters included in this book present and discuss the new advances and challenges in these fields, using several methods and techniques in order to address more efficiently different and timely applications involving signal and image acquisition, image processing and analysis, image segmentation, image registration and fusion, computer simulation, image based modeling, simulation and surgical planning, image guided robot assisted surgical and image based diagnosis. The book also includes papers and reports from the first challenge on vertebra segmentation held at the workshop.

  4. Early neurological deterioration after thrombolysis: Clinical and imaging predictors

    DEFF Research Database (Denmark)

    Simonsen, Claus Z; Schmitz, Marie Louise; Hjørringgaard Madsen, Mette;


    BACKGROUND: National Institutes of Health Stroke Scale is the most common scale used in stroke patients. An increase of four points or more within 24 h signifies early neurological deterioration. We aimed to establish how often early neurological deterioration occurs in a cohort selected...... by magnetic resonance imaging and which factors predicted early neurological deterioration. METHODS: In this single-center study, we collected epidemiological, imaging and outcome data on 569 consecutive patients undergoing reperfusion therapy after magnetic resonance imaging selection. RESULTS: Of these, 33...... (5.8%) experienced early neurological deterioration. Seven were due to a symptomatic intracerebral hemorrhage, 23 were caused by extension of ischemia on follow-up imaging and three were due to progression on the basis of small vessel disease. Early neurological deterioration was predicted...

  5. Clinical software VIII for magnetic resonance imaging systems

    Energy Technology Data Exchange (ETDEWEB)

    Kohno, Satoru; Takeo, Kazuhiro [Medical Applications Department, Medical Systems Division, Shimadzu Corporation, Kyoto (Japan)


    This report describes the latest techniques of MRA (magnetic resonance angiography) and the brain attack diagnosis protocol which are now effectively utilized in the Shimadzu-Marconi MAGNEX ECLIPSE MRI (magnetic resonance imaging) system (1.5 tesla type) and the MAGNEX POLARIS MRI system (1.0 tesla type). As for the latest techniques for MRA, this report refers to the SLINKY (sliding interleaved ky) technique, which provides high-resolution images over a wide range in the direction of slice, without using contrast agent, and to the iPass technique which enables highly reliable CE-MRA (contrast-enhanced magnetic resonance angiography), through easy and simple operation. Also reported are the techniques of diffusion imaging and perfusion imaging, utilized for stroke assessment. (author)

  6. Assessing image-guided implant surgery in today's clinical practice. (United States)

    Norkin, Frederic J; Ganeles, Jeffrey; Zfaz, Samuel; Modares, Alireza


    As implant dentistry has progressed, greater emphasis has been placed on natural-looking tooth replacement, minimally invasive techniques, and better cost efficiencies, with implant positioning being guided by the desired prosthetic outcome. Image-guided surgery is a technique that merges preoperative diagnostic imaging with computer-based planning tools to facilitate surgical and restorative plans and procedures. This article discusses the intricacies of guided implant surgery, including 3-dimensional presurgical planning and the challenges of maintaining guide stability during surgical execution.

  7. IT Infrastructure to support the secondary use of routinely acquired clinical imaging data for research. (United States)

    Leung, Kai Yan Eugene; van der Lijn, Fedde; Vrooman, Henri A; Sturkenboom, Miriam C J M; Niessen, Wiro J


    We propose an infrastructure for the automated anonymization, extraction and processing of image data stored in clinical data repositories to make routinely acquired imaging data available for research purposes. The automated system, which was tested in the context of analyzing routinely acquired MR brain imaging data, consists of four modules: subject selection using PACS query, anonymization of privacy sensitive information and removal of facial features, quality assurance on DICOM header and image information, and quantitative imaging biomarker extraction. In total, 1,616 examinations were selected based on the following MRI scanning protocols: dementia protocol (246), multiple sclerosis protocol (446) and open question protocol (924). We evaluated the effectiveness of the infrastructure in accessing and successfully extracting biomarkers from routinely acquired clinical imaging data. To examine the validity, we compared brain volumes between patient groups with positive and negative diagnosis, according to the patient reports. Overall, success rates of image data retrieval and automatic processing were 82.5 %, 82.3 % and 66.2 % for the three protocol groups respectively, indicating that a large percentage of routinely acquired clinical imaging data can be used for brain volumetry research, despite image heterogeneity. In line with the literature, brain volumes were found to be significantly smaller (p-value <0.001) in patients with a positive diagnosis of dementia (915 ml) compared to patients with a negative diagnosis (939 ml). This study demonstrates that quantitative image biomarkers such as intracranial and brain volume can be extracted from routinely acquired clinical imaging data. This enables secondary use of clinical images for research into quantitative biomarkers at a hitherto unprecedented scale.

  8. The issues and tentative solutions for contrast-enhanced magnetic resonance imaging at ultra-high field strength. (United States)

    Fries, Peter; Morelli, John N; Lux, Francois; Tillement, Olivier; Schneider, Günther; Buecker, Arno


    Magnetic resonance imaging (MRI) performed at ultra-high field strengths beyond 3 Tesla (T) has become increasingly prevalent in research and preclinical applications. As such, the inevitable clinical implementation of such systems lies on the horizon. The major benefit of ultra-high field MRI is the markedly increased signal-to-noise ratios achievable, enabling acquisition of MR images with simultaneously greater spatial and temporal resolution. However, at field strengths higher than 3 T, the efficacy of Gd(III)-based contrast agents is diminished due to decreased r1 relaxivity, somewhat limiting imaging of the vasculature and contrast-enhanced imaging of tumors. There have been extensive efforts to design new contrast agents with high r1 relaxivities based on macromolecular compounds or nanoparticles; however, the efficacy of these agents at ultra-high field strengths has not yet been proven. The aim of this review article is to provide an overview of the basic principles of MR contrast enhancement processes and to highlight the main factors influencing relaxivity. In addition, challenges and opportunities for contrast-enhanced MRI at ultra-high field strengths will be explored. Various approaches for the development of effective contrast agent molecules that are suitable for a broad spectrum of applied field strengths will be discussed in the context of the current literature.

  9. A comparison of clinical symptoms and magnetic resonance images in temporomandibular joint disorders

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yong Suk; Hwang, Eui Hwan; Lee, Sang Rae [Kyunghee University College of Medicine, Seoul (Korea, Republic of)


    To determine the relationship between clinical symptoms and magnetic resonance (MR) images in patients presenting with temporomandibular joint (TMJ) disorders. This study was based on 172 joints in 86 patients presenting with TMJ disorders. Joint pain and sound during jaw opening and closing movements were recorded, and the possible relationship between disc positions and bony changes of the condylar head and the articular fossa in MR images in the oblique sagittal planes were examined. Data were analyzed by Chi-square test. There was no statistically significant relationship between clinical symptoms and MR images in the patients with TMJ disorders. In the patient with TMJ disorders, joint pain and sound could not be specific clinical symptoms that are related with MR image findings, and asymptomatic joint did not necessarily imply that the joints are normal according to MR image findings.

  10. MR imaging of uterine carcinoma: correlation with clinical and pathologic findings. (United States)

    Posniak, H V; Olson, M C; Dudiak, C M; Castelli, M J; Dolan, J; Wisniewski, R A; Isaacs, J H; Sharma, S K; Bychkov, V


    Thirteen patients with clinical stages I and II endometrial carcinoma were examined with magnetic resonance (MR) imaging before surgery. Depth of invasion and stage of disease were assessed, and the results were compared with those from MR images of the surgical specimens and pathologic findings. Staging with MR imaging was accurate in 11 of 13 patients (85%). Our results agree with previous reports that MR imaging is an accurate, noninvasive method of assessing depth of myometrial invasion and cervical involvement. We anticipate that MR imaging will have an increasing role in treatment of patients with endometrial carcinoma.

  11. Radiolabelled leukocytes for imaging inflammation: how radiochemistry affects clinical use. (United States)

    Ballinger, J R; Gnanasegaran, G


    Indium-111((111)In)-labelled leukocytes were introduced for imaging inflammation about 25 years ago. A few years later methods to label leukocytes with Technetium-99m ((99m)Tc) were developed, but the two radiolabels cannot be used interchangeably. The amount of radioactivity which can be administered with (111)In is low, because of its 67-h half-life and associated radiation dose. This results in low count density in images. However, (111)In labelling is very stable, with binding to intracellular macromolecules and particulates, and there is minimal urinary or faecal excretion. In contrast, (99m)Tc has a half-life of 6 h and can be administered in higher doses, resulting in improved image quality. However, (99m)Tc labelling is less stable because the trapped form is soluble and there is excretion of (99m)Tc through both the kidneys and intestine, which limits imaging of disease in the abdomen except at early times. There is interest in extending inflammation imaging to PET. Although leukocytes can be labelled with (18)F-FDG, its half-life and stability are not optimal and radiometals such as Copper-64 are being evaluated. Despite the laborious nature of leukocyte labelling, it has yet to be replaced by direct injection agents.

  12. 3-D Reconstruction From 2-D Radiographic Images and Its Application to Clinical Veterinary Medicine (United States)

    Hamamoto, Kazuhiko; Sato, Motoyoshi

    3D imaging technique is very important and indispensable in diagnosis. The main stream of the technique is one in which 3D image is reconstructed from a set of slice images, such as X-ray CT and MRI. However, these systems require large space and high costs. On the other hand, a low cost and small size 3D imaging system is needed in clinical veterinary medicine, for example, in the case of diagnosis in X-ray car or pasture area. We propose a novel 3D imaging technique using 2-D X-ray radiographic images. This system can be realized by cheaper system than X-ray CT and enables to get 3D image in X-ray car or portable X-ray equipment. In this paper, a 3D visualization technique from 2-D radiographic images is proposed and several reconstructions are shown. These reconstructions are evaluated by veterinarians.

  13. Distinguishing clinical and imaging features of nodular regenerative hyperplasia and large regenerative nodules of the liver

    Energy Technology Data Exchange (ETDEWEB)

    Ames, J.T. [Departments of Radiology, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania (United States); Federle, M.P., E-mail: federle@stanford.ed [Departments of Radiology, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania (United States); Chopra, K. [Departments of Gastroenterology, University of Pittsburgh Medical Center Pittsburgh, Pennsylvania (United States)


    Aim: Nodular regenerative hyperplasia (NRH) and large regenerative nodules (LRN) are distinct types of hepatocellular nodules that have been confused in the radiology literature. However, distinction is critical because their clinical significance is quite different. Our purpose was to review the clinical and imaging findings in a series of patients with NRH and LRN in order to identify distinguishing clinical and imaging features. Materials and methods: This was a retrospective case series. The clinical and imaging features were compared in 36 patients with pathological proof of NRH and 23 patients with pathological evidence of LRN. Results: NRH and LRN have different predisposing factors and imaging findings. NRH is often associated with organ transplantation, myeloproliferative disease, or autoimmune processes. Livers with NRH typically do not have enhancing nodules; none of the present patients with NRH had enhancing liver masses. In contrast, LRN are often associated with Budd-Chiari syndrome. Enhancing liver masses were noted in 19 (83%) of the 23 patients with LRN. The p values for the comparisons were less than 0.001 for both enhancing liver masses and hepatic vein thrombosis. Conclusion: NRH and LRN can have distinct clinical presentations and imaging appearances. LRN often result in enhancing liver nodules, whereas NRH usually does not. Clinical and imaging information enables the distinction of LRN and NRH in many cases.

  14. Multi-institutional Quantitative Evaluation and Clinical Validation of Smart Probabilistic Image Contouring Engine (SPICE) Autosegmentation of Target Structures and Normal Tissues on Computer Tomography Images in the Head and Neck, Thorax, Liver, and Male Pelvis Areas

    DEFF Research Database (Denmark)

    Zhu, Mingyao; Bzdusek, Karl; Brink, Carsten


    Clinical validation and quantitative evaluation of computed tomography (CT) image autosegmentation using Smart Probabilistic Image Contouring Engine (SPICE).......Clinical validation and quantitative evaluation of computed tomography (CT) image autosegmentation using Smart Probabilistic Image Contouring Engine (SPICE)....

  15. Clinical application of l-123 MlBG cardiac imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Do Young [College of Medicine, Donga Univ., Busan (Korea, Republic of)


    Cardiac neurotransmission imaging allows in vivo assessment of presynaptic reuptake, neurotransmitter storage and postsynaptic receptors. Among the various neurotransmitter, I-123 MlBG is most available and relatively well-established. Metaiodobenzylguanidine (MIBG) is an analogue of the false neurotransmitter guanethidine. It is taken up to adrenergic neurons by uptake-1 mechanism as same as norepinephrine. As tagged with I-123, it can be used to image sympathetic function in various organs including heart with planar or SPECT techniques. I-123 MIBG imaging has a unique advantage to evaluate myocardial neuronal activity in which the heart has no significant structural abnormality or even no functional derangement measured with other conventional examination. In patients with cardiomyopathy and heart failure, this imaging has most sensitive technique to predict prognosis and treatment response of betablocker or ACE inhibitor. In diabetic patients, it allow very early detection of autonomic neuropathy. In patients with dangerous arrhythmia such as ventricular tachycardia or fibrillation, MIBG imaging may be only an abnormal result among various exams. In patients with ischemic heart disease, sympathetic derangement may be used as the method of risk stratification. In heart transplanted patients, sympathetic reinnervation is well evaluated. Adriamycin-induced cardiotoxicity is detected earlier than ventricular dysfunction with sympathetic dysfunction. Neurodegenerative disorder such as Parkinson's disease or dementia with Lewy bodies has also cardiac sympathetic dysfunction. Noninvasive assessment of cardiac sympathetic nerve activity with l-123 MlBG imaging may be improve understanding of the pathophysiology of cardiac disease and make a contribution to predict survival and therapy efficacy.

  16. From clinical imaging and computational models to personalised medicine and image guided interventions. (United States)

    Hawkes, David J


    This short paper describes the development of the UCL Centre for Medical Image Computing (CMIC) from 2006 to 2016, together with reference to historical developments of the Computational Imaging sciences Group (CISG) at Guy's Hospital. Key early work in automated image registration led to developments in image guided surgery and improved cancer diagnosis and therapy. The work is illustrated with examples from neurosurgery, laparoscopic liver and gastric surgery, diagnosis and treatment of prostate cancer and breast cancer, and image guided radiotherapy for lung cancer.

  17. Consensus recommendations for a standardized Brain Tumor Imaging Protocol in clinical trials

    NARCIS (Netherlands)

    B.M. Ellingson (Benjamin M.); M. Bendszus (Martin); J. Boxerman (Jerrold); D. Barboriak (Daniel); B.J. Erickson (Bradley J.); M. Smits (Marion); S.J. Nelson (Sarah J.); E. Gerstner (Elizabeth); B. Alexander (Brian); G. Goldmacher (Gregory); W. Wick (Wolfgang); M.A. Vogelbaum (Michael); M. Weller (Michael); E. Galanis (Evanthia); J. Kalpathy-Cramer (Jayashree); L. Shankar; P. Jacobs (Paula); W.B. Pope (Whitney B.); D. Yang (Dewen); C. Chung (Caroline); R.H. Knopp; S. Cha (Soonme); M.J. van den Bent (Martin); S.M. Chang (Susan); W.K. Al Yung; T.F. Cloughesy (Timothy F.); P.Y. Wen (Patrick Y.); M.R. Gilbert (Mark R.); A. Whitney (Andrew); D. Sandak (David); A. Musella (Al); C. Haynes (Chas); M. Wallace (Max); D.F. Arons (David F.); A. Kingston (Ann)


    textabstractA recent joint meeting was held on January 30, 2014, with the US Food and Drug Administration (FDA), National Cancer Institute (NCI), clinical scientists, imaging experts, pharmaceutical and biotech companies, clinical trials cooperative groups, and patient advocate groups to discuss ima

  18. Towards Building High Performance Medical Image Management System for Clinical Trials. (United States)

    Wang, Fusheng; Lee, Rubao; Zhang, Xiaodong; Saltz, Joel


    Medical image based biomarkers are being established for therapeutic cancer clinical trials, where image assessment is among the essential tasks. Large scale image assessment is often performed by a large group of experts by retrieving images from a centralized image repository to workstations to markup and annotate images. In such environment, it is critical to provide a high performance image management system that supports efficient concurrent image retrievals in a distributed environment. There are several major challenges: high throughput of large scale image data over the Internet from the server for multiple concurrent client users, efficient communication protocols for transporting data, and effective management of versioning of data for audit trails. We study the major bottlenecks for such a system, propose and evaluate a solution by using a hybrid image storage with solid state drives and hard disk drives, RESTful Web Services based protocols for exchanging image data, and a database based versioning scheme for efficient archive of image revision history. Our experiments show promising results of our methods, and our work provides a guideline for building enterprise level high performance medical image management systems.

  19. Magnetic field measurements of a clinical MR imager at 1.5 tesla (United States)

    Muhech, A.; Tellez, I.; Esteva, M.; Marrufo, O.; Jimenez, L.; Vazquez, F.; Taboada, J.; Rodriguez, A. O.


    In the clinical environment is mandatory to run periodically measurements of uniformity of the magnetic field produced by the magnet to assure good image quality. The phase difference method was used to measure the magnetic field uniformity of the 1.5 T scanner of the Instituto Nacional de Neurologia y Neurocirugia MVS. The uniformity field values showed that the imager performance is reasonably good for clinical imaging. Some concern was raised since results may not be good enough for magnetic resonance spectroscopy runs.

  20. Imaging in the diagnosis and management of peripheral psoriatic arthritis-The clinical utility of magnetic resonance imaging and ultrasonography

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Eder, Lihi; Christiansen, Sara Nysom


    Psoriatic arthritis (PsA) is an inflammatory joint disease characterised by the presence of arthritis and often enthesitis and/or spondylitis in patients with psoriasis. However, it presents a wide range of disease manifestations in various patterns. Imaging is an important part of management of Ps...... or clinical studies. Magnetic resonance imaging (MRI) allows detailed assessment of all peripheral and axial joints involved in PsA, and can visualise both inflammation and structural changes. Ultrasonography (US) can visualise many of the peripheral heterogeneous tissue compartments affected by Ps......A. In contrast to MRI, US is not useful for assessing axial involvement in the spine and sacroiliac joints. In this paper, we will provide an overview of the status, strengths and limitations of MRI and US in peripheral PsA in routine clinical practice and clinical trials....

  1. Comparison of ultrasound B-mode, strain imaging, acoustic radiation force impulse displacement and shear wave velocity imaging using real time clinical breast images (United States)

    Manickam, Kavitha; Machireddy, Ramasubba Reddy; Raghavan, Bagyam


    It has been observed that many pathological process increase the elastic modulus of soft tissue compared to normal. In order to image tissue stiffness using ultrasound, a mechanical compression is applied to tissues of interest and local tissue deformation is measured. Based on the mechanical excitation, ultrasound stiffness imaging methods are classified as compression or strain imaging which is based on external compression and Acoustic Radiation Force Impulse (ARFI) imaging which is based on force generated by focused ultrasound. When ultrasound is focused on tissue, shear wave is generated in lateral direction and shear wave velocity is proportional to stiffness of tissues. The work presented in this paper investigates strain elastography and ARFI imaging in clinical cancer diagnostics using real time patient data. Ultrasound B-mode imaging, strain imaging, ARFI displacement and ARFI shear wave velocity imaging were conducted on 50 patients (31 Benign and 23 malignant categories) using Siemens S2000 machine. True modulus contrast values were calculated from the measured shear wave velocities. For ultrasound B-mode, ARFI displacement imaging and strain imaging, observed image contrast and Contrast to Noise Ratio were calculated for benign and malignant cancers. Observed contrast values were compared based on the true modulus contrast values calculated from shear wave velocity imaging. In addition to that, student unpaired t-test was conducted for all the four techniques and box plots are presented. Results show that, strain imaging is better for malignant cancers whereas ARFI imaging is superior than strain imaging and B-mode for benign lesions representations.

  2. The SAPHO syndrome: a clinical and imaging study. (United States)

    Sallés, Meritxell; Olivé, Alejandro; Perez-Andres, Ricard; Holgado, Susana; Mateo, Lourdes; Riera, Elena; Tena, Xavier


    The purpose of this study is to describe the clinical and radiological manifestations of patients with the synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome. Retrospective study (1984-2007) was performed in a single center. All patients with the SAPHO syndrome were included. Fifty-two patients were included: 26 male, mean age at diagnosis is 42±12 years. Ostearticular involvement was present before cutaneous involvement in 59.6% of patients and concomitantly in 23.5%. Anterior chest pain was the commonest clinical manifestation, it was present in 38 patients (73%), followed by peripheral arthritis in 17 patients (32%), and sacroliliac pain in 14 patients (26.9%). Cutaneous involvement was present in 33 patients (63.5%). HLA B27 antigen was present in eight patients (17.7%). Bone scintigraphy showed an increased uptake in 42 patients (93.3%). The location of the uptake was mainly in sternoclavicular and manubriosternal joints. CT scan was performed in all "hot joints" showing sclerosis, erosions, hyperostosis, and soft tissue involvement. Refractory patients were treated mainly with pamidronate. Although SAPHO syndrome is an entity that share features that fit into a variety of established disease categories, the present study has a homogenous clinical and radiological pattern that gives support to believe that the SAPHO syndrome is an isolated clinical entity.

  3. Clinical imaging guidelines part 4: challenges in identifying, engaging and collaborating with stakeholders. (United States)

    Bettmann, Michael A; Oikarinen, Helja; Rehani, Madan; Holmberg, Ola; del Rosario Perez, Maria; Naidoo, Anusha; Do, Kyung-Hyun; Dreyer, Keith; Ebdon-Jackson, Steve


    The effective development and use of clinical imaging guidelines requires an understanding of who the stakeholders are, what their interests in the process are, and what roles they should play. If the appropriate stakeholders are not engaged in the right roles, it is unlikely that clinical imaging guidelines will be successfully developed, relied on, and actually used. Some stakeholders are obvious: for the development of clinical imaging guidelines, both imagers and those who request examinations, such as general practitioners, internists, and medical specialists, must be involved. To gain acceptance, other relevant groups are stakeholders, including medical societies, other health care professionals, insurers, health IT experts and vendors, and patients. The role of stakeholders must be dictated by their specific interest. For some, involvement in the creation of guidelines is the right role. For others, such as regulators or insurers, reviews or invitations to comment are required, and for others, such as medical educators, it is probably sufficient to provide information and create awareness. Only through a careful consideration of who the stakeholders are and what are their interests are the successful development, acceptance, and use of clinical imaging guidelines likely to occur. Future efforts must focus on collaboration, particularly among groups that create clinical imaging guidelines and those that can support their use, and on regulatory roles and mandates.

  4. Clinical indications for digital imaging in dento-alveolar trauma. Part 1: traumatic injuries. (United States)

    Cohenca, Nestor; Simon, James H; Roges, Ramon; Morag, Yoav; Malfaz, Jose Maria


    Traumatized teeth present a clinical challenge with regard to their diagnosis, treatment plan, and prognosis. Recent developments in imaging systems have enabled clinicians to visualize structural changes effectively. Computed tomography, magnetic resonance imaging and cone beam computed tomography are among the most commonly used systems for dental and maxillofacial surgery. The purpose of this review is to describe the advantages and disadvantages of each technique and the clinical application for dento-alveolar trauma. Three clinical cases are described to illustrate the potential use of the NewTom 3G for diagnosis and treatment plan of dento-alveolar traumatic injuries.

  5. Clinical application of brain imaging for the diagnosis of mood disorders: the current state of play. (United States)

    Savitz, J B; Rauch, S L; Drevets, W C


    In response to queries about whether brain imaging technology has reached the point where it is useful for making a clinical diagnosis and for helping to guide treatment selection, the American Psychiatric Association (APA) has recently written a position paper on the Clinical Application of Brain Imaging in Psychiatry. The following perspective piece is based on our contribution to this APA position paper, which specifically emphasized the application of neuroimaging in mood disorders. We present an introductory overview of the challenges faced by researchers in developing valid and reliable biomarkers for psychiatric disorders, followed by a synopsis of the extant neuroimaging findings in mood disorders, and an evidence-based review of the current research on brain imaging biomarkers in adult mood disorders. Although there are a number of promising results, by the standards proposed below, we argue that there are currently no brain imaging biomarkers that are clinically useful for establishing diagnosis or predicting treatment outcome in mood disorders.

  6. NCI Workshop Report: Clinical and Computational Requirements for Correlating Imaging Phenotypes with Genomics Signatures

    Directory of Open Access Journals (Sweden)

    Rivka Colen


    Full Text Available The National Cancer Institute (NCI Cancer Imaging Program organized two related workshops on June 26–27, 2013, entitled “Correlating Imaging Phenotypes with Genomics Signatures Research” and “Scalable Computational Resources as Required for Imaging-Genomics Decision Support Systems.” The first workshop focused on clinical and scientific requirements, exploring our knowledge of phenotypic characteristics of cancer biological properties to determine whether the field is sufficiently advanced to correlate with imaging phenotypes that underpin genomics and clinical outcomes, and exploring new scientific methods to extract phenotypic features from medical images and relate them to genomics analyses. The second workshop focused on computational methods that explore informatics and computational requirements to extract phenotypic features from medical images and relate them to genomics analyses and improve the accessibility and speed of dissemination of existing NIH resources. These workshops linked clinical and scientific requirements of currently known phenotypic and genotypic cancer biology characteristics with imaging phenotypes that underpin genomics and clinical outcomes. The group generated a set of recommendations to NCI leadership and the research community that encourage and support development of the emerging radiogenomics research field to address short-and longer-term goals in cancer research.

  7. Image Resolution in the Digital Era: Notion and Clinical Implications

    Directory of Open Access Journals (Sweden)

    Vahid Rakhshan


    Full Text Available Digital radiographs need additional metadata in order to be accurate when being converted to analog media. Resolution is a major reason of failures in proper printing or digitizing the images. This letter shortly explains the overlooked pitfalls of digital radiography and photography in dental practice, and briefly instructs the reader how to avoid or rectify common problems associated with resolution calibration of digital radiographs.

  8. Clinical and imaging considerations in primary immunodeficiency disorders: an update

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Eveline Y. [University of North Carolina at Chapel Hill, Department of Pediatrics, Chapel Hill, NC (United States); Ehrlich, Lauren [Yale School of Medicine, Department of Diagnostic Radiology, New Haven, CT (United States); Handly, Brian [University of North Carolina at Chapel Hill, Department of Radiology, Chapel Hill, NC (United States); Frush, Donald P. [Duke University Medical Center, Division of Pediatric Radiology, Durham, NC (United States); Buckley, Rebecca H. [Duke University Medical Center, Department of Pediatrics, Durham, NC (United States); Duke University School of Medicine, Department of Immunology, Durham, NC (United States)


    Primary immunodeficiencies are a group of genetically determined disorders with diverse presentations. The purpose of this review is to provide a practical and brief description of a select number of these diseases and to discuss the important role the radiologist can have in making an early diagnosis and in detecting and following disease complications. The role of diagnostic imaging and informed performance and interpretation are vital in the diagnosis, surveillance and management of all primary immunodeficiency disorders. (orig.)

  9. Image Resolution in the Digital Era: Notion and Clinical Implications (United States)

    Rakhshan, Vahid


    Digital radiographs need additional metadata in order to be accurate when being converted to analog media. Resolution is a major reason of failures in proper printing or digitizing the images. This letter shortly explains the overlooked pitfalls of digital radiography and photography in dental practice, and briefly instructs the reader how to avoid or rectify common problems associated with resolution calibration of digital radiographs. PMID:25469352

  10. The clinical value of cardiac sympathetic imaging in heart failure

    DEFF Research Database (Denmark)

    Christensen, Thomas Emil; Kjaer, Andreas; Hasbak, Philip


    The autonomic nervous system plays an important role in the pathology of heart failure. The single-photon emission computed tomography tracer iodine-123-metaiodobenzylguanidine ((123) I-MIBG) can be used to investigate the activity of the predominant neurotransmitter of the sympathetic nervous...... system, norepinephrine. Also, positron emission tomography tracers are being developed for the same purpose. With (123) I-MIBG as a starting point, this brief review introduces the modalities used for cardiac sympathetic imaging....

  11. Image Resolution in the Digital Era: Notion and Clinical Implications

    Directory of Open Access Journals (Sweden)

    Vahid Rakhshan


    Full Text Available Digital radiographs need additional metadata in order to be accurate when being converted to analog media. Resolution is a major reason of failures in proper printing or digitizing the images. This letter shortly explains the overlooked pitfalls of digital radiography and photography in dental practice, and briefly instructs the reader how to avoid or rectify common problems associated with resolution calibration of digital radiographs.

  12. Miscellaneous conditions of the shoulder: Anatomical, clinical, and pictorial review emphasizing potential pitfalls in imaging diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Farid, Nikdokht [University of California San Diego, Department of Radiology, 200 West Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States); Bruce, Dean [University of California San Diego, Department of Radiology, 200 West Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States); University of Alberta, Edmonton, Alberta (Canada); Chung, Christine B. [University of California San Diego, Department of Radiology, 200 West Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States)], E-mail:


    The purpose of this article is to review the key imaging findings in major categories of pathology affecting the shoulder joint including hydroxyapatite deposition disease, rotator cuff interval pathology, acromioclavicular joint pathology, glenohumeral osteoarthrosis, and synovial inflammatory processes, with specific emphasis on findings that have associated pitfalls in imaging diagnosis. The pathophysiology and clinical manifestations of the above mentioned categories of pathology will be reviewed, followed in each section by a detailed pictorial review of the key imaging findings in each category including plain film, computed tomography, and magnetic resonance imaging findings as applicable. Imaging challenges that relate to both diagnosis and characterization will be addressed with each type of pathology. The goal is that after reading this article, the reader will be able to recognize the key imaging findings in major categories of pathology affecting the shoulder joint and will become familiar with the potential pitfalls in their imaging diagnosis.

  13. Avulsion Fractures of the Knee: Imaging Findings and Clinical Significance

    Directory of Open Access Journals (Sweden)

    Babak Sanei


    Full Text Available The knee is an intricate joint with numerous tendinous, ligamentous, and meniscal attachments, which make it particularly vulnerable to complex injuries after trauma. A variety of avulsion fractures of the knee can occur, including Segond and reverse Segond fractures; avulsions of the anterior and posterior cruciate ligaments; arcuate complex avulsion; iliotibial band avulsion; avulsions of the biceps femoris, semimembranous, and quadriceps tendons; Sinding-Larsen-Johansson syndrome; and Osgood- Schlatter disease. These fractures often have a subtle appearance at conventional radiography, which is typically the first imaging modality performed in these cases. Advanced imaging modalities, particularly magnetic resonance imaging, are helpful and can provide valuable additional information for adequately defining the extent of damage. The onus is on the radiologist to identify the pattern of injury and to understand the substantial underlying damage that it frequently represents. Conveying this information to the referring clinician is crucial and represents the first step toward additional evaluation and probable orthopedic referral. By recognizing the significance of these injuries at initial presentation, radiologists can facilitate appropriate patient work-up and prevent the chronic morbidity associated with delayed treatment.

  14. Cystic synovial sarcomas: imaging features with clinical and histopathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Nakanishi, Hirofumi; Araki, Nobuhito [Department of Orthopedic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3, Nakamichi, Higashinari-Ku, 537-8511, Osaka (Japan); Sawai, Yuka [Department of Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Kudawara, Ikuo [Department of Orthopedic Surgery, Osaka National Hospital, Osaka (Japan); Mano, Masayuki; Ishiguro, Shingo [Department of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Ueda, Takafumi; Yoshikawa, Hideki [Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka (Japan)


    To characterize the radiological and clinicopathologic features of cystic synovial sarcoma. Seven patients with primary cystic synovial sarcoma were evaluated. Computed tomography (CT) and magnetic resonance (MR) imaging were undertaken at the first presentation. The diagnosis of synovial sarcoma was made on the basis of histological examinations followed by molecular analysis. Radiological and clinicopathologic findings were reviewed. CT showed well-defined soft tissue mass without cortical bone erosion and invasion. Calcification was seen at the periphery of the mass in three cases. T2-weighted MR images showed multilocular inhomogeneous intensity mass in all cases, five of which showed fluid-fluid levels. On gross appearance, old and/or fresh hematomas were detected in six cases. In the one remaining case, microscopic hemorrhage in the cystic lumen was proven. Four cases had poorly differentiated areas. In five cases prominent hemangiopericytomatous vasculature was observed. Histologic grade was intermediate in one tumor and high in six. One case had a history of misdiagnosis for tarsal tunnel syndrome, one for lymphadenopathy, two for sciatica and two for hematoma. All cystic synovial sarcomas demonstrated multilocularity with well-circumscribed walls and internal septae. Synovial sarcoma should be taken into consideration in patients with deeply situated multicystic mass with triple signal intensity on T2-weighted MR imaging. (orig.)

  15. DWI of Prostate Cancer: Optimal b-Value in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Guglielmo Manenti


    Full Text Available Aim. To compare the diagnostic performance of diffusion weighted imaging (DWI using b-values of 1000 s/mm2 and 2000 s/mm2 at 3 Tesla (T for the evaluation of clinically significant prostate cancer. Matherials and Methods. Seventy-eight prostate cancer patients underwent a 3T MRI scan followed by radical prostatectomy. DWI was performed using b-values of 0, 1000, and 2000 s/mm2 and qualitatively analysed by two radiologists. ADC maps were obtained at b-values of 1000 and 2000 s/mm2 and quantitatively analyzed in consensus. Results. For diagnosis of 78 prostate cancers the accuracy of DWI for the young reader was significantly greater at b = 2000 s/mm2 for the peripheral zone (PZ but not for the transitional zone (TZ. For the experienced reader, DWI did not show significant differences in accuracy between b-values of 1000 and 2000 s/mm2. The quantitative analysis in the PZ and TZ was substantially superimposable between the two b-values, albeit with a higher accuracy with a b-value of 2000 s/mm2. Conclusions. With a b-value of 2000 s/mm2 at 3T both readers differentiated clinical significant cancer from benign tissue; higher b-values can be helpful for the less experienced readers.

  16. Interconnecting smartphone, image analysis server, and case report forms in clinical trials for automatic skin lesion tracking in clinical trials (United States)

    Haak, Daniel; Doma, Aliaa; Gombert, Alexander; Deserno, Thomas M.


    Today, subject's medical data in controlled clinical trials is captured digitally in electronic case report forms (eCRFs). However, eCRFs only insufficiently support integration of subject's image data, although medical imaging is looming large in studies today. For bed-side image integration, we present a mobile application (App) that utilizes the smartphone-integrated camera. To ensure high image quality with this inexpensive consumer hardware, color reference cards are placed in the camera's field of view next to the lesion. The cards are used for automatic calibration of geometry, color, and contrast. In addition, a personalized code is read from the cards that allows subject identification. For data integration, the App is connected to an communication and image analysis server that also holds the code-study-subject relation. In a second system interconnection, web services are used to connect the smartphone with OpenClinica, an open-source, Food and Drug Administration (FDA)-approved electronic data capture (EDC) system in clinical trials. Once the photographs have been securely stored on the server, they are released automatically from the mobile device. The workflow of the system is demonstrated by an ongoing clinical trial, in which photographic documentation is frequently performed to measure the effect of wound incision management systems. All 205 images, which have been collected in the study so far, have been correctly identified and successfully integrated into the corresponding subject's eCRF. Using this system, manual steps for the study personnel are reduced, and, therefore, errors, latency and costs decreased. Our approach also increases data security and privacy.

  17. Clinical use of gadobutrol for contrast-enhanced magnetic resonance imaging of neurological diseases

    Directory of Open Access Journals (Sweden)

    Cheng KT


    Full Text Available Kenneth T Cheng1, Hannah Y Cheng2, Kam Leung31Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA; 2Freelance Technical Writer, New Orleans, LA, USA; 3National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD, USAAbstract: Contrast-enhanced magnetic resonance imaging (CE-MRI is an important clinical tool for diagnosing neurological diseases. The appropriate use of a suitable MRI contrast agent or contrast pharmaceutical is essential for CE-MRI to produce desirable diagnostic images. Currently, there are seven contrast agents (CAs or pharmaceuticals approved for clinical imaging of the central nervous system (CNS in the US, Europe, or Japan. All of the clinically approved CAs are water-soluble gadolinium-based contrast agents (GBCAs which do not penetrate the CNS blood–brain barrier (BBB. These agents are used for imaging CNS areas without a BBB, or various pathologies, such as tumors and infection that break down the BBB and allow CAs to enter into the surrounding parenchyma. Clinically, GBCAs are most useful for detecting primary and secondary cerebral neoplastic lesions. Among these CNS GBCAs, gadobutrol (Gd-BT-DO3A, Gadovist™ is a neutral, nonionic, macrocyclic compound that showed promising results from clinical trials of CNS imaging. In comparison with other GBCAs, Gd-BT-DO3A has relatively high in vitro kinetic stability and r1 relaxivity. Gd-BT-DO3A has been recently approved by the US Food and Drug Administration (FDA in 2011 for CNS imaging. A review of available literature shows that Gd-BT-DO3A exhibits similar safety and clinical efficacy profiles to other GBCAs. Gd-BT-DO3A has the distinguishing feature that it is the only clinical agent commercially available in a formulation of 1.0 M concentration with a relatively higher in vitro T1 shortening per unit volume than other clinical GBCAs which are only

  18. Clinical evaluation of Synthetic Aperture Sequential Beamforming and Tissue Harmonic Imaging

    DEFF Research Database (Denmark)

    Brandt, Andreas Hjelm; Hemmsen, Martin Christian; Hansen, Peter Møller


    This study determines if the data reduction achieved by the combination Synthetic Aperture Sequential Beamforming (SASB) and Tissue Harmonic Imaging (THI) affects image quality. SASB-THI was evaluated against the combination of Dynamic Received Focusing and Tissue Harmonic Imaging (DRF-THI). A BK...... liver pathology were scanned to set a clinical condition, where ultrasonography is often performed. A total of 114 sequences were recorded and evaluated by five radiologists. The evaluators were blinded to the imaging technique, and each sequence was shown twice with different left-right positioning...

  19. Indigenous development of an imaging flow cytometer for clinical and biological applications (United States)

    J, Veerendra Kalyan; Srinivasan, Rajesh; Gorthi, Sai Siva


    Flow cytometry is a benchmark technique used for basic research and clinical diagnosis of various diseases. Despite being a high-throughput technique, it fails in capturing the morphology of cells being analyzed. Imaging flow cytometry is a combination of flow-cytometry and digital microscopy, which offers advantages of both the techniques. In this paper, we report on the development of an indigenous Imaging Flow Cytometer, realized with the combination of Optics, Microfluidics, and High-speed imaging. A custom-made bright-field transmission microscope is used to capture images of cells flowing across the microfluidic device. High-throughput morphological analysis on suspension of yeast cells is presented.

  20. Handbook of nuclear medicine and molecular imaging principles and clinical applications

    CERN Document Server

    Kim, Edmund E; Tateishi, Ukihide; Baum, Richard P


    This handbook will provide updated information on nuclear medicine and molecular imaging techniques as well as its clinical applications, including radionuclide therapy, to trainees and practitioners of nuclear medicine, radiology and general medicine. Updated information on nuclear medicine and molecular imaging are vitally important and useful to both trainees and existing practitioners. Imaging techniques and agents are advancing and changing so rapidly that concise and pertinent information are absolutely necessary and helpful. It is hoped that this handbook will help readers be better equipped for the utilization of new imaging methods and treatments using radiopharmaceuticals.

  1. Imaging diagnosis in relapsing polychondritis and correlation with clinical and serological data

    Energy Technology Data Exchange (ETDEWEB)

    Thaiss, W.M.; Nikolaou, K.; Horger, M. [Eberhard Karls University, Department of Radiology, Diagnostic and Interventional Radiology, Tuebingen (Germany); Spengler, W.; Xenitidis, T.; Henes, J. [Eberhard Karls University, Department of Internal Medicine II, Tuebingen (Germany); Spira, D. [Eberhard Karls University, Department of Radiology, Diagnostic and Interventional Radiology, Tuebingen (Germany); University Medical Center Heidelberg, Diagnostic and Interventional Radiology, Heidelberg (Germany)


    We hypothesize that imaging findings from CT and MRI correlate better with clinical markers for assessment of disease activity in patients with the rare relapsing polychondritis (RPC) than with serological inflammatory markers. Retrospective database search at our institution identified 28 patients (13 females; age 49.0 years ± 15.0 SD) with RP between September 2004 and March 2014. Institutional review board approval was obtained for this retrospective data analysis. All patients had clinically proven RPC with at least two episodes of active disease. Of those, 18 patients were examined with CT- and MRI and presented all morphologic features of RPC like bronchial/laryngeal/auricular cartilage thickness, contrast enhancement, increased T2-signal intensity. Imaging data was subsequently correlated with corresponding clinical symptoms like fever, dyspnea, stridor, uveitis, pain, hearing impairment as well as with acute-phase-inflammatory parameters like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). The clinical parameters were in good agreement with imaging findings and clinical symptoms such as tracheal wall thickening and dyspnea (r =0.65 p = 0.05), joint synovitis on MRI and a higher McAdam score (r = 0.84 p < 0.001). No correlations were found between inflammatory laboratory markers, imaging findings and clinical features. Imaging diagnosis in RPC using CT and/or MRI delivers information about the degree of disease activity that correlates better with clinical features than unspecific inflammatory laboratory markers. Additionally, clinically unapparent cartilage involvement can be assessed adding value to the clinical diagnosis and therapy planning in this rare disease. (orig.)

  2. Clinical assessment of chest pain and guidelines for imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gruettner, J., E-mail: [1st Department of Medicine (Cardiology), University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany); Henzler, T. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany); Sueselbeck, T. [1st Department of Medicine (Cardiology), University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany); Fink, C. [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany); Borggrefe, M.; Walter, T. [1st Department of Medicine (Cardiology), University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim (Germany)


    For many emergency facilities, risk assessment of patients with diffuse chest pain still poses a major challenge. In their currently valid recommendations, the international cardiological societies have defined a standardized assessment of the prognostically relevant cardiac risk criteria. Here the classic sequence of basic cardiac diagnostics including case history (cardiac risk factors), physical examination (haemodynamic and respiratory vital parameters), ECG (ST segment analysis) and laboratory risk markers (troponin levels) is paramount. The focus is, on the one hand, on timely indication for percutaneous catheterization, especially in patients at high cardiac risk with or without ST-segment elevation in the ECG, and, on the other hand, on the possibility of safely discharging patients with intermediate or low cardiac risk after non-invasive exclusion of a coronary syndrome. For patients in the intermediate or low risk group, physical or pharmacological stress testing in combination with scintigraphy, echocardiography or magnetic resonance imaging is recommended in addition to basic diagnostics. Moreover, the importance of non-invasive coronary imaging, primarily cardiac CT angiography (CCTA), is increasing. Current data show that in intermediate or low risk patients this method is suitable to reliably rule out coronary heart disease. In addition, attention is paid to the major differential diagnoses of acute coronary syndrome, particularly pulmonary embolism and aortic dissection. Here the diagnostic method of choice is thoracic CT, possibly also in combination with CCTA aiming at a triple rule-out.

  3. Online survey system for image-based clinical guideline studies using the Delphi method. (United States)

    Harper, Todd M; Teng, Chia-Chi


    The increasing use of health information technology (HIT) is due to a rising interest in improving the quality of health care. HIT has the potential to reduce cost and transform services. Proper clinical support systems will contribute to the meaningful use of HIT systems by providing a wide array of data to clinicians for the diagnosis and treatments. Clinical guidelines, created by a consensus of experts, can be put in place to assist physicians in making clinical decisions. Delphi methods are commonly used to create consensus from surveys completed by a team of experts. Image based studies could create guidelines that standardize severity, deformity or other clinical classifications. As these studies were traditionally conducted using paper based media, the cost and time requirement often make the process impractical. Ware proposing a web based system to aid medical researchers in conducting image based Delphi studies for improved clinical guidelines and decision support.

  4. Small-Animal Imaging Using Clinical Positron Emission Tomography/Computed Tomography and Super-Resolution

    Directory of Open Access Journals (Sweden)

    Frank P. DiFilippo


    Full Text Available Considering the high cost of dedicated small-animal positron emission tomography/computed tomography (PET/CT, an acceptable alternative in many situations might be clinical PET/CT. However, spatial resolution and image quality are of concern. The utility of clinical PET/CT for small-animal research and image quality improvements from super-resolution (spatial subsampling were investigated. National Electrical Manufacturers Association (NEMA NU 4 phantom and mouse data were acquired with a clinical PET/CT scanner, as both conventional static and stepped scans. Static scans were reconstructed with and without point spread function (PSF modeling. Stepped images were postprocessed with iterative deconvolution to produce super-resolution images. Image quality was markedly improved using the super-resolution technique, avoiding certain artifacts produced by PSF modeling. The 2 mm rod of the NU 4 phantom was visualized with high contrast, and the major structures of the mouse were well resolved. Although not a perfect substitute for a state-of-the-art small-animal PET/CT scanner, a clinical PET/CT scanner with super-resolution produces acceptable small-animal image quality for many preclinical research studies.

  5. Resolution improvement of brain PET images using prior information from MRI: clinical application on refractory epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Silva-Rodríguez, Jesus [Instituto de Investigaciones Sanitarias (IDIS), Santiago de Compostela (Spain); Tsoumpas, Charalampos [University of Leeds, Leeds (United Kingdom); Aguiar, Pablo; Cortes, Julia [Nuclear Medicine Department, University Hospital (CHUS), Santiago de Compostela (Spain); Urdaneta, Jesus Lopez [Instituto de Investigaciones Sanitarias (IDIS), Santiago de Compostela (Spain)


    An important counterpart of clinical Positron Emission Tomography (PET) for early diagnosis of neurological diseases is its low resolution. This is particularly important when evaluating diseases related to small hypometabolisms such as epilepsy. The last years, new hybrid systems combining PET with Magnetic Resonance (MR) has been increasingly used for several different clinical applications. One of the advantages of MR is the production of high spatial resolution images and a potential application of PET-MR imaging is the improvement of PET resolution using MR information. A potential advantage of resolution recovery of PET images is the enhancement of contrast delivering at the same time better detectability of small lesions or hypometabolic areas and more accurate quantification over these areas. Recently, Shidahara et al (2009) proposed a new method using wavelet transforms in order to produce PET images with higher resolution. We optimised Shidahara’s method (SFS-RR) to take into account possible shortcomings on the particular clinical datasets, and applied it to a group of patients diagnosed with refractory epilepsy. FDG-PET and MRI images were acquired sequentially and then co-registered using software tools. A complete evaluation of the PET/MR images was performed before and after the correction, including different parameters related with PET quantification, such as atlas-based metabolism asymmetry coefficients and Statistical Parametric Mapping results comparing to a database of 87 healthy subjects. Furthermore, an experienced physician analyzed the results of non-corrected and corrected images in order to evaluate improvements of detectability on a visual inspection. Clinical outcome was used as a gold standard. SFS-RR demonstrated to have a positive impact on clinical diagnosis of small hypometabolisms. New lesions were detected providing additional clinically relevant information on the visual inspection. SPM sensitivity for the detection of small

  6. Clinics in diagnostic imaging (112). Perinatal lethal hypophosphatasia (PLH). (United States)

    Kritsaneepaiboon, S; Jaruratanasirikul, S; Dissaneevate, S


    A two-hour-old female infant presented with respiratory distress and short limbs. Neonatal radiographs showed micromelic dwarfism and generalised demineralisation, especially at the ribs, long bones of both forearms and both fibulae. The spine showed a flattened shape. All long bones showed metaphyseal irregularities and flaring. Normal serum calcium and elevated serum phosphorus were found, while serum alkaline phosphatase was markedly reduced. A diagnosis of perinatal lethal hypophosphatasia was made. The aetiology, clinical manifestations, radiographical findings, laboratory assays, prenatal diagnosis and treatment of hypophosphatasia are discussed.

  7. Clinics in diagnostic imaging (114). Rupture of the right testis. (United States)

    Muttarak, M; Thinyu, S; Lojanapiwat, B


    A 22-year-old man, who was kicked in the scrotum during Thai kickboxing, presented with a painful swelling of the right hemiscrotum. Scrotal ultrasonography (US) showed an enlarged right testis with heterogeneous echogenicity and irregular contours. Colour Doppler US showed vascularity in the upper pole of the right testis and avascularity in the lower pole. Emergency exploration of the right hemiscrotum revealed laceration of the lower pole of the right testis. Debridement and repair of the right testis were performed. The clinical manifestations, role of US and US findings of scrotal trauma are discussed.

  8. Development and clinical translation of OTIS: a wide-field OCT imaging device for ex-vivo tissue characterization (United States)

    Munro, Elizabeth A.; Rempel, David; Danner, Christine; Atchia, Yaaseen; Valic, Michael S.; Berkeley, Andrew; Davoudi, Bahar; Magnin, Paul A.; Akens, Margarete; Done, Susan J.; Kulkarni, Supriya; Leong, Wey-Liang; Wilson, Brian C.


    We have developed an automated, wide-field optical coherence tomography (OCT)-based imaging device (OTISTM Perimeter Medical Imaging) for peri-operative, ex-vivo tissue imaging. This device features automated image acquisition, enabling rapid capture of high-resolution (15 μm) OCT images from samples up to 10 cm in diameter. We report on the iterative progression of device development from phantom and pre-clinical (tumor xenograft) models through to initial clinical results. We discuss the challenges associated with proving a novel imaging technology against the clinical "gold standard" of conventional post-operative pathology.

  9. A Survey of DICOM Viewer Software to Integrate Clinical Research and Medical Imaging. (United States)

    Haak, Daniel; Page, Charles-E; Deserno, Thomas M


    The digital imaging and communications in medicine (DICOM) protocol is the leading standard for image data management in healthcare. Imaging biomarkers and image-based surrogate endpoints in clinical trials and medical registries require DICOM viewer software with advanced functionality for visualization and interfaces for integration. In this paper, a comprehensive evaluation of 28 DICOM viewers is performed. The evaluation criteria are obtained from application scenarios in clinical research rather than patient care. They include (i) platform, (ii) interface, (iii) support, (iv) two-dimensional (2D), and (v) three-dimensional (3D) viewing. On the average, 4.48 and 1.43 of overall 8 2D and 5 3D image viewing criteria are satisfied, respectively. Suitable DICOM interfaces for central viewing in hospitals are provided by GingkoCADx, MIPAV, and OsiriX Lite. The viewers ImageJ, MicroView, MIPAV, and OsiriX Lite offer all included 3D-rendering features for advanced viewing. Interfaces needed for decentral viewing in web-based systems are offered by Oviyam, Weasis, and Xero. Focusing on open source components, MIPAV is the best candidate for 3D imaging as well as DICOM communication. Weasis is superior for workflow optimization in clinical trials. Our evaluation shows that advanced visualization and suitable interfaces can also be found in the open source field and not only in commercial products.

  10. Clinical 3T MR imaging: mastering the challenges. (United States)

    Tanenbaum, Lawrence N


    3T MRI is ready to meet the needs of clinical practice. SAR limitations are minimized by technical advances and surface coils are available for all core applications. With appropriate adjustments to scanning protocols, one can master the challenges of scanning at 3T; studies of the brain, spine, chest, abdomen, pelvis, vasculature, and extremities can be consistently higher in quality than are those obtained at 1.5T. The superior studies that are obtainable at 3T have great appeal to clinicians who are sophisticated about MR technology in areas, such as neurology, orthopedics, vascular surgery, and oncology,and encourage a shift in referrals toward practices that invest in higher field technology. The greater sensitivity to magnetic susceptibility offers unique benefits in functional neuroimaging, and available software/hardware packages enhance clinical setting feasibility, which adds a source of new referrals. The greater overall signal of 3T can be manipulated to make scanning more comfortable and with less motion artifact because scan times could be half as long. Spectacular anatomic delineation that is provided by high-definition scanning at true 1024 resolution can improve preoperative assessment and may improve sensitivity to smaller lesions. 3T provides practices with an advantage that is sought increasingly by high field strength purchasers in a competitive market. Only cost considerations stand in the way of the eventual domination of 3T systems in the high field strength market.

  11. Clinical image: Hydatid disease of the chest wall

    Energy Technology Data Exchange (ETDEWEB)

    Graham, R.J.; Berlin, J.W.; Ghahremani, G.G. [Northwestern Univ., Evanston, IL (United States)


    Hydatid disease is rarely encountered among the population of the United States, but it affects several million people in sheep-raising regions of the world. Human infestation with Echinococcus granulosus begins following ingestion of its ova, which are excreted into the contaminated water during the usual dog-sheep cycle. Hydatid cysts will then develop most frequently in the liver (75% of cases) and lungs (15%) of the human host. Skeletal involvement has been reported to occur in only 0.5-4.0% of patients in the endemic areas. Because of the rarity and perplexing imaging features of hydatid disease involving the chest wall, we wish herein to present a case evaluated recently at our institution. 5 refs., 1 fig.

  12. Clinical use and evaluation of coded excitation in B-mode images

    DEFF Research Database (Denmark)

    Misaridis, Athanasios; Pedersen, M. H.; Jensen, Jørgen Arendt


    of the compressed output and its stability to attenuation. Images of a wire phantom in water show that the range sidelobes resulting from pulse compression are below the acoustic noise, which was at 50 dB for the pulsed images. For images acquired from an attenuation phantom, the proposed compression scheme......Use of long encoded waveforms can be advantageous in ultrasound imaging, as long as the pulse compression mechanism ensures low range sidelobes and preserves both axial resolution and contrast. A coded excitation/compression scheme was previously presented by our group, which is based...... on a predistorted FM excitation and a mismatched compression filter designed for medical ultrasonic applications. The attenuation effect, analyzed in this paper using the ambiguity function and simulations, dictated the choice of the coded waveform. In this study clinical images, images of wire phantoms...

  13. Positron Emission Tomography: Current Challenges and Opportunities for Technological Advances in Clinical and Preclinical Imaging Systems. (United States)

    Vaquero, Juan José; Kinahan, Paul


    Positron emission tomography (PET) imaging is based on detecting two time-coincident high-energy photons from the emission of a positron-emitting radioisotope. The physics of the emission, and the detection of the coincident photons, give PET imaging unique capabilities for both very high sensitivity and accurate estimation of the in vivo concentration of the radiotracer. PET imaging has been widely adopted as an important clinical modality for oncological, cardiovascular, and neurological applications. PET imaging has also become an important tool in preclinical studies, particularly for investigating murine models of disease and other small-animal models. However, there are several challenges to using PET imaging systems. These include the fundamental trade-offs between resolution and noise, the quantitative accuracy of the measurements, and integration with X-ray computed tomography and magnetic resonance imaging. In this article, we review how researchers and industry are addressing these challenges.

  14. Clinical Utility of Positron Emission Tomography Magnetic Resonance Imaging (PET-MRI) in Gastrointestinal Cancers. (United States)

    Matthews, Robert; Choi, Minsig


    Anatomic imaging utilizing both CT (computed tomography) and MRI (magnetic resonance imaging) limits the assessment of cancer metastases in lymph nodes and distant organs while functional imaging like PET (positron emission tomography) scan has its limitation in spatial resolution capacity. Hybrid imaging utilizing PET-CT and PET-MRI are novel imaging modalities that are changing the current landscape in cancer diagnosis, staging, and treatment response. MRI has shown to have higher sensitivity in soft tissue, head and neck pathology, and pelvic disease, as well as, detecting small metastases in the liver and bone compared to CT. Combining MRI with PET allows for detection of metastases that may have been missed with current imaging modalities. In this review, we will examine the clinical utility of FDG PET-MRI in the diagnosis and staging of gastrointestinal cancers with focus on esophageal, stomach, colorectal, and pancreatic cancers. We will also explore its role in treatment response and future directions associated with it.

  15. Use of magnetic resonance imaging for detecting clinically and mammographically occult ductal carcinoma in situ. (United States)

    Lo, G; Cheung, Polly S Y


    We report on two cases where breast magnetic resonance imaging examination changed clinical management. Breast magnetic resonance imaging is now recognised as an indispensable adjunctive examination to mammography and ultrasound. In each of the two cases described, breast magnetic resonance imaging revealed unsuspected, extensive, and mammographically and ultrasonologically occult, ductal carcinoma in situ. In each of these cases, planned breast conserving surgery was changed to mastectomy. The success of breast conservation treatment depends on removal of all tumour with clear margins at the time of surgery. Magnetic resonance imaging is now considered the most sensitive method for evaluating the extent of breast cancer. Breast magnetic resonance imaging has a very high sensitivity for invasive carcinoma (near 100%), and recent studies show its specificity in high-risk patients is between 93 and 99%. Magnetic resonance imaging may well be proven an important adjunctive examination in patients who have dense breasts or extensive fibrocystic change.

  16. Multiparametric magnetic resonance imaging of the prostate: technical aspects and role in clinical management. (United States)

    Costa, Daniel N; Pedrosa, Ivan; Roehrborn, Claus; Rofsky, Neil M


    The heterogeneity and largely indolent nature of prostate cancer require better tools to avoid overdetection of low-risk disease and improve diagnostic accuracy in high-risk patients. During the last 3 decades, magnetic resonance imaging (MRI) has evolved to become the most accurate imaging technique for prostate cancer detection and staging, with a promising role in risk stratification. Because each MRI technique has advantages and limitations, state of the art of the so-called multiparametric MRI of the prostate is achieved combining anatomical T2-weighted imaging integrated with other techniques in which image contrast is related to the pathophysiology of the disease, such as diffusion-weighted imaging, dynamic contrast-enhanced imaging, and MR spectroscopy. After reviewing this article, readers will understand the clinical challenges in the management of patients with confirmed or suspected prostate cancer, when and how multiparametric MRI of the prostate can provide meaningful information, and how to perform and interpret it.

  17. High throughput tools to access images from clinical archives for research. (United States)

    Murphy, Shawn N; Herrick, Christopher; Wang, Yanbing; Wang, Taowei David; Sack, Darren; Andriole, Katherine P; Wei, Jesse; Reynolds, Nathaniel; Plesniak, Wendy; Rosen, Bruce R; Pieper, Steven; Gollub, Randy L


    Historically, medical images collected in the course of clinical care have been difficult to access for secondary research studies. While there is a tremendous potential value in the large volume of studies contained in clinical image archives, Picture Archiving and Communication Systems (PACS) are designed to optimize clinical operations and workflow. Search capabilities in PACS are basic, limiting their use for population studies, and duplication of archives for research is costly. To address this need, we augment the Informatics for Integrating Biology and the Bedside (i2b2) open source software, providing investigators with the tools necessary to query and integrate medical record and clinical research data. Over 100 healthcare institutions have installed this suite of software tools that allows investigators to search medical record metadata including images for specific types of patients. In this report, we describe a new Medical Imaging Informatics Bench to Bedside (mi2b2) module ( ), available now as an open source addition to the i2b2 software platform that allows medical imaging examinations collected during routine clinical care to be made available to translational investigators directly from their institution's clinical PACS for research and educational use in compliance with the Health Insurance Portability and Accountability Act (HIPAA) Omnibus Rule. Access governance within the mi2b2 module is customizable per institution and PACS minimizing impact on clinical systems. Currently in active use at our institutions, this new technology has already been used to facilitate access to thousands of clinical MRI brain studies representing specific patient phenotypes for use in research.

  18. Updating magnetic resonance imaging of small bowel: Imaging protocols and clinical indications

    Institute of Scientific and Technical Information of China (English)

    Jiong Zhu; Jian-Rong Xu; Hong-Xia Gong; Yan Zhou


    High soft tissue contrast resolution,acquisition of multi-planar images and the possibility to obtain functional information make magnetic resonance an interesting imaging technique to evaluate the small bowel disease.The absence of ionizing radiation is an important feature of magnetic resonance imaging (MRI) examinations because inflammatory diseases such as Crohn's disease (CD) are studied most frequently,which are prevalent among children and young adults.MRI,using modern equipment and a rigorous technical approach,can offer detailed morphologic information and functional data on the small bowel.This article discusses the MRI protocols for small bowel and the MR imaging findings of small bowel diseases,such as CD and small bowel neoplasms.

  19. SU-E-P-10: Imaging in the Cardiac Catheterization Lab - Technologies and Clinical Applications

    Energy Technology Data Exchange (ETDEWEB)

    Fetterly, K [Mayo Clinic, Rochester, MN (United States)


    Purpose: Diagnosis and treatment of cardiovascular disease in the cardiac catheterization laboratory is often aided by a multitude of imaging technologies. The purpose of this work is to highlight the contributions to patient care offered by the various imaging systems used during cardiovascular interventional procedures. Methods: Imaging technologies used in the cardiac catheterization lab were characterized by their fundamental technology and by the clinical applications for which they are used. Whether the modality is external to the patient, intravascular, or intracavity was specified. Specific clinical procedures for which multiple modalities are routinely used will be highlighted. Results: X-ray imaging modalities include fluoroscopy/angiography and angiography CT. Ultrasound imaging is performed with external, trans-esophageal echocardiography (TEE), and intravascular (IVUS) transducers. Intravascular infrared optical coherence tomography (IVOCT) is used to assess vessel endothelium. Relatively large (>0.5 mm) anatomical structures are imaged with x-ray and ultrasound. IVUS and IVOCT provide high resolution images of vessel walls. Cardiac CT and MRI images are used to plan complex cardiovascular interventions. Advanced applications are used to spatially and temporally merge images from different technologies. Diagnosis and treatment of coronary artery disease frequently utilizes angiography and intra-vascular imaging, and treatment of complex structural heart conditions routinely includes use of multiple imaging modalities. Conclusion: There are several imaging modalities which are routinely used in the cardiac catheterization laboratory to diagnose and treat both coronary artery and structural heart disease. Multiple modalities are frequently used to enhance the quality and safety of procedures. The cardiac catheterization laboratory includes many opportunities for medical physicists to contribute substantially toward advancing patient care.

  20. Quantifying trabecular bone material anisotropy and orientation using low resolution clinical CT images: A feasibility study. (United States)

    Nazemi, S Majid; Cooper, David M L; Johnston, James D


    Accounting for spatial variation of trabecular material anisotropy and orientation can improve the accuracy of quantitative computed tomography-based finite element (FE) modeling of bone. The objective of this study was to investigate the feasibility of quantifying trabecular material anisotropy and orientation using clinical computed tomography (CT). Forty four cubic volumes of interest were obtained from micro-CT images of the human radius. Micro-FE modeling was performed on the samples to obtain orthotropic stiffness entries as well as trabecular orientation. Simulated computed tomography images (0.32, 0.37, and 0.5mm isotropic voxel sizes) were created by resampling micro-CT images with added image noise. The gray-level structure tensor was used to derive fabric eigenvalues and eigenvectors in simulated CT images. For 'best case' comparison purposes, Mean Intercept Length was used to define fabric from micro-CT images. Regression was used in combination with eigenvalues, imaged density and FE to inversely derive the constants used in Cowin and Zysset-Curnier fabric-elasticity equations, and for comparing image derived fabric-elasticity stiffness entries to those obtained using micro-FE. Image derived eigenvectors (which indicated trabecular orientation) were then compared to orientation derived using micro-FE. When using clinically available voxel sizes, gray-level structure tensor derived fabric combined with Cowin's equations was able to explain 94-97% of the variance in orthotropic stiffness entries while Zysset-Curnier equations explained 82-88% of the variance in stiffness. Image derived orientation deviated by 4.4-10.8° from micro-FE derived orientation. Our results indicate potential to account for spatial variation of trabecular material anisotropy and orientation in subject-specific finite element modeling of bone using clinically available CT.

  1. Clinical characteristics and diagnostic imaging of cranial osteoblastoma. (United States)

    Pelargos, Panayiotis E; Nagasawa, Daniel T; Ung, Nolan; Chung, Lawrance K; Thill, Kimberly; Tenn, Stephen; Gopen, Quinton; Yang, Isaac


    Benign osteoblastoma is a rare, vascular, osteoid-forming bone tumor that occurs even less frequently in the cranial bones. Benign osteoblastoma of the cranium affects women slightly more often than men and typically presents in the first three decades of life. Although clinical presentation can vary depending on location, cranial osteoblastoma usually presents as a painful, non-mobile, subcutaneous mass or swelling. On CT scan, it generally presents as a well-demarcated, mixed lytic and sclerotic lesion, with enlarged diploe, thinning outer and/or inner tables, and varying degrees of calcification. It is hypo to isointense on T1-weighted MRI and has variable presentation on T2-weighted MRI. Gross total resection is the definitive treatment, while subtotal resection is utilized when it is necessary to preserve critical adjacent neurovascular structures.

  2. MRI of respiratory dynamics with 2D steady-state free-precession and 2D gradient echo sequences at 1.5 and 3 Tesla: an observer preference study

    Energy Technology Data Exchange (ETDEWEB)

    Fabel, M.; Biederer, J. [University Hospital Schleswig-Holstein, Department of Diagnostic Radiology, Kiel (Germany); Wintersperger, B.J.; Dietrich, O. [University Hospital Munich, Department of Clinical Radiology, Munich (Germany); Eichinger, M.; Puderbach, M. [German Cancer Research Center, Department of Oncological Diagnostics and Therapy, Heidelberg (Germany); Fink, C.; Schoenberg, S.O. [University Hospital Heidelberg-Mannheim, Department of Clinical Radiology, Mannheim (Germany); Kauczor, H.U. [University Hospital Heidelberg, Department of Diagnostic Radiology, Heidelberg (Germany)


    To compare the image quality of dynamic lung MRI with variations of steady-state free-precession (SSFP) and gradient echo (GRE) cine techniques at 1.5 T and 3 T. Ventilated porcine lungs with simulated lesions inside a chest phantom and four healthy human subjects were assessed with SSFP (TR/TE = 2.9/1.22 ms; 3 ima/s) and GRE sequences (TR/TE=2.34/0.96 ms; 8 ima/s) as baseline at 1.5 and 3 T. Modified SSFPs were performed with nine to ten images/s (parallel imaging factors 2 and 3). Image quality for representative structures and artifacts was ranked by three observers independently. At 1.5 T, standard SSFP achieved the best image quality with superior spatial resolution and signal, but equal temporal resolution to GRE. SSFP with improved temporal resolution was ranked second best. Further acceleration (PI factor 3) was of no benefit, but increased artifacts. At 3 T, GRE outranged SSFP imaging with high lesion signal intensity, while artifacts on SSFP images increased visibly. At 1.5 T, a modified SSFP with moderate parallel imaging (PI factor 2) was considered the best compromise of temporal and spatial resolution. At 3 T, GRE sequences remain the best choice for dynamic lung MRI. (orig.)

  3. Medical imaging in clinical applications algorithmic and computer-based approaches

    CERN Document Server

    Bhateja, Vikrant; Hassanien, Aboul


    This volume comprises of 21 selected chapters, including two overview chapters devoted to abdominal imaging in clinical applications supported computer aided diagnosis approaches as well as different techniques for solving the pectoral muscle extraction problem in the preprocessing part of the CAD systems for detecting breast cancer in its early stage using digital mammograms. The aim of this book is to stimulate further research in medical imaging applications based algorithmic and computer based approaches and utilize them in real-world clinical applications. The book is divided into four parts, Part-I: Clinical Applications of Medical Imaging, Part-II: Classification and clustering, Part-III: Computer Aided Diagnosis (CAD) Tools and Case Studies and Part-IV: Bio-inspiring based Computer Aided diagnosis techniques. .

  4. 3D-2D registration of cerebral angiograms: a method and evaluation on clinical images. (United States)

    Mitrovic, Uroš; Špiclin, Žiga; Likar, Boštjan; Pernuš, Franjo


    Endovascular image-guided interventions (EIGI) involve navigation of a catheter through the vasculature followed by application of treatment at the site of anomaly using live 2D projection images for guidance. 3D images acquired prior to EIGI are used to quantify the vascular anomaly and plan the intervention. If fused with the information of live 2D images they can also facilitate navigation and treatment. For this purpose 3D-2D image registration is required. Although several 3D-2D registration methods for EIGI achieve registration accuracy below 1 mm, their clinical application is still limited by insufficient robustness or reliability. In this paper, we propose a 3D-2D registration method based on matching a 3D vasculature model to intensity gradients of live 2D images. To objectively validate 3D-2D registration methods, we acquired a clinical image database of 10 patients undergoing cerebral EIGI and established "gold standard" registrations by aligning fiducial markers in 3D and 2D images. The proposed method had mean registration accuracy below 0.65 mm, which was comparable to tested state-of-the-art methods, and execution time below 1 s. With the highest rate of successful registrations and the highest capture range the proposed method was the most robust and thus a good candidate for application in EIGI.

  5. Cerebral amyloid angiopathy-related inflammation: imaging findings and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Martucci, Matia [Vall d' Hebron University Hospital, Neuroradiology Unit, Radiology Department (IDI), Barcelona (Spain); Catholic University of Sacred Heart, ' ' A. Gemelli' ' University Hospital, Department of Radiological Sciences, Rome (Italy); Sarria, Silvana; Coscojuela, Pilar; Vert, Carla; Siurana, Sahyly; Auger, Cristina; Rovira, Alex [Vall d' Hebron University Hospital, Neuroradiology Unit, Radiology Department (IDI), Barcelona (Spain); Toledo, Manuel [Vall d' Hebron University Hospital, Epilepsy Unit, Neurology Department, Barcelona (Spain)


    We aim to investigate the clinical onset, computed tomography (CT) and magnetic resonance (MR) imaging findings, and follow-up of patients with cerebral amyloid angiopathy (CAA)-related inflammation, an uncommon but clinically striking presentation of CAA. We retrospectively reviewed the clinical manifestations, CT/MR imaging findings, and outcome of ten consecutive patients with CAA-related inflammation. In each patient, a brain CT study was performed at hospital admission, and brain MR imaging was carried out 2 to 4 days later. Clinical and radiologic follow-up findings were evaluated in all patients. The most common clinical onset was rapidly progressive cognitive decline, followed by focal neurological signs. Brain CT/MR showed unenhanced expansive subcortical lesions, corresponding to areas of vasogenic edema, associated with chronic lobar, cortical, or cortical-subcortical micro/macrohemorrhages. Clinical symptoms recovered in a few weeks under treatment in eight patients and spontaneously in the remaining two. MRI follow-up at 2 to 12 months after treatment showed resolution of the lesions. Three patients experienced symptomatic disease recurrence, with new lesions on CT/MR. In the absence of histological data, early recognition of the clinical symptoms and typical radiologic features of CAA-related inflammation is essential to enable timely establishment of proper treatment. (orig.)

  6. Upper Limb Evaluation in Duchenne Muscular Dystrophy: Fat-Water Quantification by MRI, Muscle Force and Function Define Endpoints for Clinical Trials (United States)

    Ricotti, Valeria; Evans, Matthew R. B.; Sinclair, Christopher D. J.; Butler, Jordan W.; Ridout, Deborah A.; Hogrel, Jean-Yves; Emira, Ahmed; Morrow, Jasper M.; Reilly, Mary M.; Hanna, Michael G.; Janiczek, Robert L.; Matthews, Paul M.; Yousry, Tarek A.; Muntoni, Francesco; Thornton, John S.


    Objective A number of promising experimental therapies for Duchenne muscular dystrophy (DMD) are emerging. Clinical trials currently rely on invasive biopsies or motivation-dependent functional tests to assess outcome. Quantitative muscle magnetic resonance imaging (MRI) could offer a valuable alternative and permit inclusion of non-ambulant DMD subjects. The aims of our study were to explore the responsiveness of upper-limb MRI muscle-fat measurement as a non-invasive objective endpoint for clinical trials in non-ambulant DMD, and to investigate the relationship of these MRI measures to those of muscle force and function. Methods 15 non-ambulant DMD boys (mean age 13.3 y) and 10 age-gender matched healthy controls (mean age 14.6 y) were recruited. 3-Tesla MRI fat-water quantification was used to measure forearm muscle fat transformation in non-ambulant DMD boys compared with healthy controls. DMD boys were assessed at 4 time-points over 12 months, using 3-point Dixon MRI to measure muscle fat-fraction (f.f.). Images from ten forearm muscles were segmented and mean f.f. and cross-sectional area recorded. DMD subjects also underwent comprehensive upper limb function and force evaluation. Results Overall mean baseline forearm f.f. was higher in DMD than in healthy controls (pfat transformation of muscle with loss of muscle force and function. PMID:27649492

  7. MR imaging of the temporomandibular joint at 0. 2 T with surface coils; Clinical evaluations

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Kaoru; Imanaka, Masahiro; Yamamoto, Akira (Tsurumi Univ., Yokohama (Japan). School of Dental Medicine)


    MR imaging of 138 patients (276 temporomandibular joints, TMJs) were made at 0.2 T with surface coil from January 1990 to December 1990. One hundred and ninety out of 276 TMJs presented suggestive signs and symptoms of internal derangements of the TMJs. Double-contrast arthrotomography of 108 patients (117 TMJs) were made from January 1990 to December 1990. Thirty-eight out of 276 TMJs were studied with both MR imaging and double-contrast arthrotomography. Ninety TMJs were normal with superior disk position by MR images. Seventy TMJs showed anterior disk displacement with reduction and 78 TMJs showed anterior disk displacement without reduction by MR images. Two TMJs were arthrotomographically normal with superior disk position. Eight TMJs showed anterior disk displacement with reduction, 61 TMJs showed anterior disk displancement without reduction and 32 TMJs showed anterior disk displacement associated with perforation of the posterior attachment of the disk. MR imaging at 0.2 T was effective measures for diagnosis of internal derangements of the TMJ. Double-contrast arthrotomography was superior to MR imaging in detecting capsular adhesions and perforation of the posterior attachment of the disk. Concerning information on the disk position, diagnostic accuracy of MR imaging was equal to double-contrast arthrotomography. When internal derangement of the TMJ is suspected by clinical findings, our first choice of imaging is MR imaging. When osteoarthrosis of the TMJ is suspected by routine radiographs, the first choice of imaging is tomography and/or double-contrast arthrotomography. (author).

  8. Diffusion tensor imaging for Alzheimer's disease: A review of concepts and potential clinical applicability


    Luciano de Gois Vasconcelos; Sonia Maria Dozzi Brucki; Andrea Parolin Jackowiski; Orlando Francisco Amodeo Bueno


    Abstract In view of the urgent need to identify an early and specific biomarker for Alzheimer's disease (AD), a PubMed database search was performed using the terms "Alzheimer disease" and "Diffusion Magnetic Resonance Imaging" to enable review of Diffusion tensor imaging (DTI) concepts and its potential clinical role in AD evaluation. Detailed analysis of selected abstracts showed that the main DTI measures, fractional anisotropy and apparent diffusion coefficient, indicators of fiber tract ...

  9. Whole-body MR imaging. Practical issues, clinical applications, and future directions. (United States)

    Eustace, S J; Walker, R; Blake, M; Yucel, E K


    Whole-body MR imaging is in evolution, and although accepting and recognizing limitations, it is likely that both technique and incurred acquisition times will shorten over the next decade. Although the development of dedicated whole-body MR scanners appears to offer the greatest promise for the future, the development of moving table tops, optimized pulse sequences, and advances in gradient technology now facilitate practical whole-body MR imaging using existing clinical systems.

  10. Whole-body magnetic resonance imaging: techniques, clinical indications, and future applications. (United States)

    Walker, R E; Eustace, S J


    This article reviews developments in both pulse sequence design and gradient technology that facilitate rapid imaging of the whole body. It discusses its application in patients with bone marrow neoplasms, including metastases, lymphoma, and myeloma and emphasizes the value of whole-body magnetic resonance imaging in patients with known vertebral lesions to detect other bone lesions that are easier to biopsy. It outlines possible applications in well-defined clinical situations, including pregnancy and unknown primary tumor.

  11. Magnetic resonance imaging for the clinical management of rectal cancer patients

    DEFF Research Database (Denmark)

    Beets-Tan, Regina G H; Lambregts, Doenja M J; Maas, Monique


    OBJECTIVES: To develop guidelines describing a standardised approach regarding the acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for clinical staging and restaging of rectal cancer. METHODS: A consensus meeting of 14 abdominal imaging experts from the European...... Society of Gastrointestinal and Abdominal Radiology (ESGAR) was conducted following the RAND-UCLA Appropriateness Method. Two independent (non-voting) chairs facilitated the meeting. Two hundred and thirty-six items were scored by participants for appropriateness and classified subsequently as appropriate...

  12. Companion diagnostics and molecular imaging-enhanced approaches for oncology clinical trials. (United States)

    Van Heertum, Ronald L; Scarimbolo, Robert; Ford, Robert; Berdougo, Eli; O'Neal, Michael


    In the era of personalized medicine, diagnostic approaches are helping pharmaceutical and biotechnology sponsors streamline the clinical trial process. Molecular assays and diagnostic imaging are routinely being used to stratify patients for treatment, monitor disease, and provide reliable early clinical phase assessments. The importance of diagnostic approaches in drug development is highlighted by the rapidly expanding global cancer diagnostics market and the emergent attention of regulatory agencies worldwide, who are beginning to offer more structured platforms and guidance for this area. In this paper, we highlight the key benefits of using companion diagnostics and diagnostic imaging with a focus on oncology clinical trials. Nuclear imaging using widely available radiopharmaceuticals in conjunction with molecular imaging of oncology targets has opened the door to more accurate disease assessment and the modernization of standard criteria for the evaluation, staging, and treatment responses of cancer patients. Furthermore, the introduction and validation of quantitative molecular imaging continues to drive and optimize the field of oncology diagnostics. Given their pivotal role in disease assessment and treatment, the validation and commercialization of diagnostic tools will continue to advance oncology clinical trials, support new oncology drugs, and promote better patient outcomes.

  13. Utilizing data grid architecture for the backup and recovery of clinical image data. (United States)

    Liu, Brent J; Zhou, M Z; Documet, J


    Grid Computing represents the latest and most exciting technology to evolve from the familiar realm of parallel, peer-to-peer and client-server models. However, there has been limited investigation into the impact of this emerging technology in medical imaging and informatics. In particular, PACS technology, an established clinical image repository system, while having matured significantly during the past ten years, still remains weak in the area of clinical image data backup. Current solutions are expensive or time consuming and the technology is far from foolproof. Many large-scale PACS archive systems still encounter downtime for hours or days, which has the critical effect of crippling daily clinical operations. In this paper, a review of current backup solutions will be presented along with a brief introduction to grid technology. Finally, research and development utilizing the grid architecture for the recovery of clinical image data, in particular, PACS image data, will be presented. The focus of this paper is centered on applying a grid computing architecture to a DICOM environment since DICOM has become the standard for clinical image data and PACS utilizes this standard. A federation of PACS can be created allowing a failed PACS archive to recover its image data from others in the federation in a seamless fashion. The design reflects the five-layer architecture of grid computing: Fabric, Resource, Connectivity, Collective, and Application Layers. The testbed Data Grid is composed of one research laboratory and two clinical sites. The Globus 3.0 Toolkit (Co-developed by the Argonne National Laboratory and Information Sciences Institute, USC) for developing the core and user level middleware is utilized to achieve grid connectivity. The successful implementation and evaluation of utilizing data grid architecture for clinical PACS data backup and recovery will provide an understanding of the methodology for using Data Grid in clinical image data backup for

  14. Metabolic brain imaging correlated with clinical features of brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Alavi, J.; Alavi, A.; Dann, R.; Kushner, M.; Chawluk, J.; Powlis, W.; Reivich, M.


    Nineteen adults with brain tumors have been studied with positron emission tomography utilizing FDG. Fourteen had biopsy proven cerebral malignant glioma, one each had meningioma, hemangiopericytoma, primitive neuroectodermal tumor (PNET), two had unbiopsied lesions, and one patient had an area of biopsy proven radiation necrosis. Three different patterns of glucose metabolism are observed: marked increase in metabolism at the site of the known tumor in (10 high grade gliomas and the PNET), lower than normal metabolism at the tumor (in 1 grade II glioma, 3 grade III gliomas, 2 unbiopsied low density nonenhancing lesions, and the meningioma), no abnormality (1 enhancing glioma, the hemangiopericytoma and the radiation necrosis.) The metabolic rate of the tumor or the surrounding brain did not appear to be correlated with the history of previous irradiation or chemotherapy. Decreased metabolism was frequently observed in the rest of the affected hemisphere and in the contralateral cerebellum. Tumors of high grade or with enhancing CT characteristics were more likely to show increased metabolism. Among the patients with proven gliomas, survival after PETT scan tended to be longer for those with low metabolic activity tumors than for those with highly active tumors. The authors conclude that PETT may help to predict the malignant potential of tumors, and may add useful clinical information to the CT scan.

  15. Feasibility and Merits of Performing Preclinical Imaging on Clinical Radiology and Nuclear Medicine Systems

    Directory of Open Access Journals (Sweden)

    Mehmet Bilgen


    Full Text Available Aim. Researchers have limited access to systems dedicated to imaging small laboratory animals. This paper aims to investigate the feasibility and merits of performing preclinical imaging on clinical systems. Materials and Methods. Scans were performed on rat and mouse models of diseases or injuries on four radiology systems, tomosynthesis, computed tomography (CT, positron emission tomography/computed tomography (PET-CT, and Magnetic Resonance Imaging (MRI, based on the availability at the author’s institute. Results. Tomosysthesis delineated soft tissue anatomy and hard tissue structure with superb contrast and spatial resolution at minimal scan time and effort. CT allowed high resolution volumetric visualization of bones. Molecular imaging with PET was useful for detecting cancerous tissue in mouse but at the expense of poor resolution. MRI depicted abnormal or intervened tissue at quality and resolution sufficient for experimental studies. The paper discussed limitations of the clinical systems in preclinical imaging as well as challenges regarding the need of additional gadgets, modifications, or upgrades required for longitudinally scanning animals under anesthesia while monitoring their vital signs. Conclusion. Clinical imaging technologies can potentially make cost-effective and efficient contributions to preclinical efforts in obtaining anatomical, structural, and functional information from the underlying tissue while minimally compromising the data quality in certain situations.

  16. Clinical image quality perception and its relation to NECR measurements in PET

    Energy Technology Data Exchange (ETDEWEB)

    Queiroz, Marcelo A [Department of Medical Imaging, Division of Nuclear Medicine, University Hospital Zürich, Zürich, CH-8091 (Switzerland); Wollenweber, Scott D [GE Healthcare, Waukesha, 53186 WI (United States); Schulthess, Gustav von [Department of Medical Imaging, Division of Nuclear Medicine, University Hospital Zürich, Zürich, CH-8091 (Switzerland); Delso, Gaspar [GE Healthcare, Waukesha, 53186 WI (United States); Veit-Haibach, Patrick [Department of Medical Imaging, Division of Nuclear Medicine, University Hospital Zürich, Zürich, CH-8091 (Switzerland); Department of Medical Imaging, Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, CH-8091 (Switzerland)


    The purpose of this study is to describe a clinical relation of noise equivalent count rate (NECR) - an objective measurement of positron emission tomography (PET) systems - measured in a large number of patients, to clinical image quality of PET and their relation to 18F-fluoro-2-deoxyglucose (FDG) activity and patient's weight. A total of 71 consecutive patients were evaluated in this retrospective study. All data was automatically analysed using Matlab to estimate the noise equivalent count rate. Then, image quality was evaluated according to two subjective scores: the IQ local score was a 3-point scale assigned to each bed position in all patients and the IQ global score was a 10-point scale assigned after evaluating the coronal whole-body PET. Patient data was also analysed concerning weight, body mass index, FDG dose at the start of acquisition (D{sub Acq}), presence of bowel uptake and presence of FDG-positive pathologic lesions. Two additional parameters were defined for each patient: the ratio between D{sub Acq} and patient weight (R{sub DW}) and the ratio between D{sub Acq} and patient BMI (R{sub DBMI}). Clinically perceived image quality in PET has a significant positive correlation with NECR measured in patients, R{sub DW}, R{sub DBMI} and presence of pathologic lesions. Clinical image quality furthermore has significant negative correlation with weight, body mass index (BMI) and presence of bowel uptake. Thresholds of R{sub DW} and R{sub DBMI} in which clinical IQ is good to excellent in more than 90% of the patients were 2.6 and 8.0, respectively. Clinically perceived image quality in PET systems is positively and significantly related to NECR measured in patients. An optimal threshold for the R{sub DW} and R{sub DBMI} was defined in which clinical IQ is good to excellent in more than 90% of patients. With this data, it is possible to extrapolate technical as well as clinical image quality to other PET system and to predict clinical image

  17. MO-C-BRB-06: Translating NIH / NIBIB funding to clinical reality in quantitative diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Jackson, E. [University of Wisconsin (United States)


    Diagnostic radiology and radiation oncology are arguably two of the most technologically advanced specialties in medicine. The imaging and radiation medicine technologies in clinical use today have been continuously improved through new advances made in the commercial and academic research arenas. This symposium explores the translational path from research through clinical implementation. Dr. Pettigrew will start this discussion by sharing his perspectives as director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB). The NIBIB has focused on promoting research that is technological in nature and has high clinical impact. We are in the age of precision medicine, and the technological innovations and quantitative tools developed by engineers and physicists working with physicians are providing innovative tools that increase precision and improve outcomes in health care. NIBIB funded grants lead to a very high patenting rate (per grant dollar), and these patents have higher citation rates by other patents, suggesting greater clinical impact, as well. Two examples of clinical translation resulting from NIH-funded research will be presented, in radiation therapy and diagnostic imaging. Dr. Yu will describe a stereotactic radiotherapy device developed in his laboratory that is designed for treating breast cancer with the patient in the prone position. It uses 36 rotating Cobalt-60 sources positioned in an annular geometry to focus the radiation beam at the system’s isocenter. The radiation dose is delivered throughout the target volume in the breast by constantly moving the patient in a planned trajectory relative to the fixed isocenter. With this technique, the focal spot dynamically paints the dose distribution throughout the target volume in three dimensions. Dr. Jackson will conclude this symposium by describing the RSNA Quantitative Imaging Biomarkers Alliance (QIBA), which is funded in part by NIBIB and is a synergistic collaboration

  18. Canavan disease - unusual imaging features in a child with mild clinical presentation

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Ho V.; Ishak, Gisele E. [University of Washington, Department of Radiology, Seattle Children' s Hospital, Seattle, WA (United States)


    Canavan disease is a rare hereditary leukodystrophy that manifests in early childhood. Associated with rapidly progressive clinical deterioration, it usually results in death by the third year of life. The predominant MRI appearance is diffuse and symmetrical white matter disease. We discuss an atypical, late presentation of Canavan disease with a benign clinical course and uncharacteristic imaging features. This case introduces a previously unreported pattern of diffuse cortical abnormality without significant white matter involvement. (orig.)

  19. Crime Scene Investigation: Clinical Application of Chemical Shift Imaging as a Problem Solving Tool (United States)


    MDW/SGVU SUBJECT: Professional Presentation Approva l 26 FEB 2016 1. Your paper, entitled Crime Scene Investigation: Clinical Aoolication of...or technical information as a publication/presentation, a new 59 MDW Form 3039 must be submitted for review and approval.] Crime Scene Investiga...tion: Clinical Application of Chemical Shift Imaging as a Problem Solving Tool 1. TITLE OF MATERIAL TO BE PUBLISHED OR PRESENTED Crime Scene

  20. Management of Low-Flow Vascular Malformations: Clinical Presentation, Classification, Patient Selection, Imaging and Treatment

    Energy Technology Data Exchange (ETDEWEB)

    McCafferty, Ian, E-mail: [Queen Elizabeth Hospital Birmingham (QEHB) & Birmingham Children’s Hospital (BCH) (United Kingdom)


    This review article aims to give an overview of the current state of imaging, patient selection, agents and techniques used in the management of low-flow vascular malformations. The review includes the current classifications for low-flow vascular malformations including the 2014 updates. Clinical presentation and assessment is covered with a detailed section on the common sclerosant agents used to treat low-flow vascular malformations, including dosing and common complications. Imaging is described with a guide to a simple stratification of the use of imaging for diagnosis and interventional techniques.

  1. Childhood extracranial neoplasms: the role of imaging in drug development and clinical trials

    Energy Technology Data Exchange (ETDEWEB)

    Fowkes, Lucy A.; Koh, Dow-Mu; MacVicar, David [Royal Marsden NHS Foundation Trust, Department of Radiology, Sutton, Surrey (United Kingdom); Collins, David J.; Jerome, Neil P. [Institute of Cancer Research, Cancer Research UK and EPSRC Cancer Imaging Centre, Sutton, Surrey (United Kingdom); Chua, Sue C. [Royal Marsden NHS Foundation Trust, Nuclear Medicine and PET Department, Sutton, Surrey (United Kingdom); Pearson, Andrew D.J. [Royal Marsden NHS Foundation Trust, Paediatric Drug Development Unit, Children and Young People' s Unit, Sutton, Surrey (United Kingdom)


    Cancer is the leading cause of death in children older than 1 year of age and new drugs are necessary to improve outcomes. Imaging is crucial to the drug development process and assessment of therapeutic response. In adults, tumours are often assessed with CT using size criteria. Unfortunately, techniques established in adults are not necessarily applicable in children due to differing pathophysiology, ability to cooperate and increased susceptibility to ionising radiation. MRI, in particular quantitative MRI, has to date not been fully utilised in children with extracranial neoplasms. The specific challenges of imaging in children, the potential for functional imaging techniques to inform upon and their inclusion in clinical trials are discussed. (orig.)

  2. Towards the routine use of brain imaging to aid the clinical diagnosis of disorders of consciousness. (United States)

    Coleman, M R; Davis, M H; Rodd, J M; Robson, T; Ali, A; Owen, A M; Pickard, J D


    Clinical audits have highlighted the many challenges and dilemmas faced by clinicians assessing persons with disorders of consciousness (vegetative state and minimally conscious state). The diagnostic decision-making process is highly subjective, dependent upon the skills of the examiner and invariably dictated by the patients' ability to move or speak. Whilst a considerable amount has been learnt since Jennett and Plum coined the term 'vegetative state', the assessment process remains largely unchanged; conducted at the bedside, using behavioural assessment tools, which are susceptible to environmental and physiological factors. This has created a situation where the rate of misdiagnosis is unacceptably high (up to 43%). In order to address these problems, various functional brain imaging paradigms, which do not rely upon the patient's ability to move or speak, have been proposed as a source of additional information to inform the diagnostic decision making process. Although accumulated evidence from brain imaging, particularly functional magnetic resonance imaging (fMRI), has been encouraging, the empirical evidence is still based on relatively small numbers of patients. It remains unclear whether brain imaging is capable of informing the diagnosis beyond the behavioural assessment and whether brain imaging has any prognostic utility. In this study, we describe the functional brain imaging findings from a group of 41 patients with disorders of consciousness, who undertook a hierarchical speech processing task. We found, contrary to the clinical impression of a specialist team using behavioural assessment tools, that two patients referred to the study with a diagnosis of vegetative state did in fact demonstrate neural correlates of speech comprehension when assessed using functional brain imaging. These fMRI findings were found to have no association with the patient's behavioural presentation at the time of investigation and thus provided additional diagnostic

  3. Clinical Experience With A High Resolution Digital Imaging System For Gastro-Intestinal Radiology (United States)

    Edmonds, E. W.; Rowlands, J. A.; Hynes, D. M.; Toth, B. D.; Porter, A. J.


    In our department, it is planned that the gastro-intestinal fluoroscopic area will be equipped entirely with digital imaging systems. The use of the 1024 X 1024 pixel frame store, backed by a hard disc for rapid image transfer, and the production of hard copy on a laser imager has reached the point where clinical efficacy and acceptance are assured. The further addition of facilities for annotation and the application of digital post-processing techniques are being explored both at the clinical site and at the research laboratorieS. The use of laser imaging has produced a further improvement in image quality and some of the practical problems related to this apparatus will be described. The availability of larger capacity laser disc image storage enables the local area network or "mini-PACS" system for fluoroscopy areas to become a concept worthy of investigation. We present our experience over a number of years with these systems, together with our latest investigations into potential applications of laser technology to the practice of radiology in a busy imaging centre.

  4. Clinical review: Clinical imaging of the sublingual microcirculation in the critically ill - where do we stand?

    NARCIS (Netherlands)

    R. Bezemer (Rick); S.A. Bartels (Sebastiaan); J. Bakker (Jan); C. Ince (Can)


    textabstractA growing body of evidence exists associating depressed microcirculatory function and morbidity and mortality in a wide array of clinical scenarios. It has been suggested that volume replacement therapy using fluids and/or blood in combination with vasoactive agents to modulate macro- an

  5. Patterns of Hepatosplenic Brucella Abscesses on Cross-Sectional Imaging: A Review of Clinical and Imaging Features. (United States)

    Heller, Tom; Bélard, Sabine; Wallrauch, Claudia; Carretto, Edoardo; Lissandrin, Raffaella; Filice, Carlo; Brunetti, Enrico


    While diffuse involvement of liver and spleen is frequently seen in brucellosis, suppurative abscesses caused by Brucella are less common but well described. With the increased availability of cross-sectional imaging techniques, reports have become more frequent. Four patients with hepatosplenic abscesses caused by Brucella spp. are described and included in a review of 115 previously published cases. Clinical characteristics and patterns on ultrasound (US) and computed tomography imaging were analyzed. Furthermore, the proportion of patients with brucellosis affected by suppurative hepatosplenic lesions was estimated. Hepatosplenic abscesses were seen in 1.2% of patients with brucellosis and were mostly caused by Brucella melitensis. Imaging analysis revealed two main distinct patterns. Solitary abscesses involving liver more frequently than spleen, and showing characteristic central calcifications, characterize the first pattern. Multiple smaller abscesses, frequent spleen involvement, and absence of calcifications characterize the second pattern. Blood and aspirate cultures were frequently negative, however, the positivity rate increased over the past years. Indirect Coombs test was positive in 96%. Half of the patients were cured by antibiotic treatment; case fatality in this series was 1.9%. Hepatosplenic abscesses due to Brucella infections have characteristic imaging findings. Clinicians should be aware of these and the proactive use of cross-sectional imaging, particularly US, should be encouraged in endemic regions.

  6. Pre-clinical and Clinical Evaluation of High Resolution, Mobile Gamma Camera and Positron Imaging Devices (United States)


    S. Majewski, R. Wojcik, A.G. Weisenberger, B. Kross, V. Popov, “Correction for the Effects of Accidental Coincidences , Compton Scatter and Object... Coincidence Imaging with a Gamma Camera ”, IEEE Transactions on Nuclear Science, Vol. 48, No. 1, Feb. 2001, Pg. 98-105. [14] R.S. Miyaoka, S.K...Coleman, “Attenuation Effects in Gamma Camera Coincidence Imaging”, IEEE Transactions on Nuclear Science, Vol. 45, No. 6, Dec. 1998, Pg. 3115-3121

  7. Digital mammography--DQE versus optimized image quality in clinical environment: an on site study (United States)

    Oberhofer, Nadia; Fracchetti, Alessandro; Springeth, Margareth; Moroder, Ehrenfried


    The intrinsic quality of the detection system of 7 different digital mammography units (5 direct radiography DR; 2 computed radiography CR), expressed by DQE, has been compared with their image quality/dose performances in clinical use. DQE measurements followed IEC 62220-1-2 using a tungsten test object for MTF determination. For image quality assessment two different methods have been applied: 1) measurement of contrast to noise ratio (CNR) according to the European guidelines and 2) contrast-detail (CD) evaluation. The latter was carried out with the phantom CDMAM ver. 3.4 and the commercial software CDMAM Analyser ver. 1.1 (both Artinis) for automated image analysis. The overall image quality index IQFinv proposed by the software has been validated. Correspondence between the two methods has been shown figuring out a linear correlation between CNR and IQFinv. All systems were optimized with respect to image quality and average glandular dose (AGD) within the constraints of automatic exposure control (AEC). For each equipment, a good image quality level was defined by means of CD analysis, and the corresponding CNR value considered as target value. The goal was to achieve for different PMMA-phantom thicknesses constant image quality, that means the CNR target value, at minimum dose. All DR systems exhibited higher DQE and significantly better image quality compared to CR systems. Generally switching, where available, to a target/filter combination with an x-ray spectrum of higher mean energy permitted dose savings at equal image quality. However, several systems did not allow to modify the AEC in order to apply optimal radiographic technique in clinical use. The best ratio image quality/dose was achieved by a unit with a-Se detector and W anode only recently available on the market.

  8. Interventional multispectral photoacoustic imaging with a clinical linear array ultrasound probe for guiding nerve blocks (United States)

    Xia, Wenfeng; West, Simeon J.; Nikitichev, Daniil I.; Ourselin, Sebastien; Beard, Paul C.; Desjardins, Adrien E.


    Accurate identification of tissue structures such as nerves and blood vessels is critically important for interventional procedures such as nerve blocks. Ultrasound imaging is widely used as a guidance modality to visualize anatomical structures in real-time. However, identification of nerves and small blood vessels can be very challenging, and accidental intra-neural or intra-vascular injections can result in significant complications. Multi-spectral photoacoustic imaging can provide high sensitivity and specificity for discriminating hemoglobin- and lipid-rich tissues. However, conventional surface-illumination-based photoacoustic systems suffer from limited sensitivity at large depths. In this study, for the first time, an interventional multispectral photoacoustic imaging (IMPA) system was used to image nerves in a swine model in vivo. Pulsed excitation light with wavelengths in the ranges of 750 - 900 nm and 1150 - 1300 nm was delivered inside the body through an optical fiber positioned within the cannula of an injection needle. Ultrasound waves were received at the tissue surface using a clinical linear array imaging probe. Co-registered B-mode ultrasound images were acquired using the same imaging probe. Nerve identification was performed using a combination of B-mode ultrasound imaging and electrical stimulation. Using a linear model, spectral-unmixing of the photoacoustic data was performed to provide image contrast for oxygenated and de-oxygenated hemoglobin, water and lipids. Good correspondence between a known nerve location and a lipid-rich region in the photoacoustic images was observed. The results indicate that IMPA is a promising modality for guiding nerve blocks and other interventional procedures. Challenges involved with clinical translation are discussed.

  9. The Value of Neurosurgical and Intraoperative Magnetic Resonance Imaging and Diffusion Tensor Imaging Tractography in Clinically Integrated Neuroanatomy Modules: A Cross-Sectional Study (United States)

    Familiari, Giuseppe; Relucenti, Michela; Heyn, Rosemarie; Baldini, Rossella; D'Andrea, Giancarlo; Familiari, Pietro; Bozzao, Alessandro; Raco, Antonino


    Neuroanatomy is considered to be one of the most difficult anatomical subjects for students. To provide motivation and improve learning outcomes in this area, clinical cases and neurosurgical images from diffusion tensor imaging (DTI) tractographies produced using an intraoperative magnetic resonance imaging apparatus (MRI/DTI) were presented and…

  10. Characterization of the onboard imaging unit for the first clinical magnetic resonance image guided radiation therapy system

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Yanle, E-mail: [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri 63110 and Department of Radiation Oncology, Mayo Clinic in Arizona, Phoenix, Arizona 85054 (United States); Rankine, Leith; Green, Olga L.; Kashani, Rojano; Li, H. Harold; Li, Hua; Rodriguez, Vivian; Santanam, Lakshmi; Wooten, H. Omar; Mutic, Sasa [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri 63110 (United States); Nana, Roger; Shvartsman, Shmaryu; Victoria, James; Dempsey, James F. [ViewRay, Inc., Oakwood Village, Ohio 44146 (United States)


    Purpose: To characterize the performance of the onboard imaging unit for the first clinical magnetic resonance image guided radiation therapy (MR-IGRT) system. Methods: The imaging performance characterization included four components: ACR (the American College of Radiology) phantom test, spatial integrity, coil signal to noise ratio (SNR) and uniformity, and magnetic field homogeneity. The ACR phantom test was performed in accordance with the ACR phantom test guidance. The spatial integrity test was evaluated using a 40.8 × 40.8 × 40.8 cm{sup 3} spatial integrity phantom. MR and computed tomography (CT) images of the phantom were acquired and coregistered. Objects were identified around the surfaces of 20 and 35 cm diameters of spherical volume (DSVs) on both the MR and CT images. Geometric distortion was quantified using deviation in object location between the MR and CT images. The coil SNR test was performed according to the national electrical manufacturers association (NEMA) standards MS-1 and MS-9. The magnetic field homogeneity test was measured using field camera and spectral peak methods. Results: For the ACR tests, the slice position error was less than 0.10 cm, the slice thickness error was less than 0.05 cm, the resolved high-contrast spatial resolution was 0.09 cm, the resolved low-contrast spokes were more than 25, the image intensity uniformity was above 93%, and the percentage ghosting was less than 0.22%. All were within the ACR recommended specifications. The maximum geometric distortions within the 20 and 35 cm DSVs were 0.10 and 0.18 cm for high spatial resolution three-dimensional images and 0.08 and 0.20 cm for high temporal resolution two dimensional cine images based on the distance-to-phantom-center method. The average SNR was 12.0 for the body coil, 42.9 for the combined torso coil, and 44.0 for the combined head and neck coil. Magnetic field homogeneities at gantry angles of 0°, 30°, 60°, 90°, and 120° were 23.55, 20.43, 18.76, 19

  11. Bone Metastases in carcinoid tumors : Clinical features, imaging characteristics, and markers of bone metabolism

    NARCIS (Netherlands)

    Meijer, WG; van der Veer, E; Jager, PL; van der Jagt, EJ; Piers, BA; Kema, IP; de Vries, EGE; Willemse, PHB


    The purpose of this study was to describe the clinical presentation of bone metastases in patients with carcinoid tumors and to determine the diagnostic value of imaging techniques and markers of bone metabolism. Methods: This retrospective study was performed on the entire group of patients with ca

  12. Clinically significant skeletal variations of the shoulder and the wrist: role of MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Mellado, J.M.; Sauri, A. [Institut de Diagnostic per la Imatge, Hospital Universitari de Tarragona Joan XXIII, Carrer Doctor Mallafre Guasch, 4, 43007 Tarragona (Spain); Calmet, J.; Domenech, S. [Department of Orthopaedic Surgery, Hospital Universitari de Tarragona Joan XXIII, Carrer Doctor Mallafre Guasch, 4, 43007 Tarragona (Spain)


    Several skeletal variations of the upper extremity may cause painful conditions or precipitate early degenerative changes, either spontaneously or in response to overuse and trauma. Magnetic resonance imaging has proved particularly useful for accurate interpretation of many of these clinically significant skeletal variations; however, the widespread use of MR imaging may have contributed to over-emphasizing their clinical importance, which is still controversial in many cases. We review, illustrate, and discuss clinically significant skeletal variations of the upper extremity as seen on MR images, particularly those involving the shoulder and the wrist. In the shoulder region, we evaluate variations of acromial and coracoid processes as well as variations and minor dysplastic deformities of the glenoid fossa. We also review different skeletal variations of the carpal region, including ulnar variance, ulnar styloid, lunate morphology, carpal coalition, and carpal accessory ossicles. The role of MR imaging in assessing the clinical importance of such conditions, whether potential, controversial, or well established, is emphasized in this review. (orig.)


    NARCIS (Netherlands)



    Magnetic resonance (MR) imaging was performed in 116 patients in whom a parotid mass lesion was clinically suspected. Eighty-six patients had benign disease. The 30 patients in whom a malignant tumor was found were further evaluated. To determine which features are characteristic of malignant paroti


    DEFF Research Database (Denmark)

    Mandl, P; Navarro-Compán, V; Terslev, L


    Objectives: To develop evidence-based recommendations on the use of imaging in the clinical management of both axial and peripheral spondyloarthritis. Methods: The task force comprised an expert group of 21 rheumatologists, radiologists and methodologists from 11 countries. Twelve key questions...

  15. Clinical benefits of combined diagnostic three-dimensional digital breast tomosynthesis and ultrasound imaging (United States)

    Varjonen, Mari; Pamilo, Martti; Raulisto, Leena


    Our goal is to evaluate diagnostic digital breast tomosynthesis and ultrasound imaging clinical value in detecting and diagnosing early stage breast cancers. Determine if fusion imaging would decrease the number of biopsies and reduce further patient workup otherwise required to establish a definitive diagnosis. This paper presents the clinical results based on the study conducted at Helsinki University Central Hospital. Presentation demonstrates clinical dual modality images and results. Tomosynthesis of amorphous selenium based full field digital mammography system will be also presented. Forty asymptomatic women enrolled in the study based on prior identification of suspicious findings on screening mammograms where the possibility of breast cancer could not be excluded. Abnormal screening mammogram findings included tumor-like densities, parenchymal asymmetries and architectural distortions. Eight women were operated and 32 were not referred for surgery. Those cases, which were operated, three lesions represented ductal carcinoma in situ, two ductal carcinomas, one atypical ductal hyperplasia, one fibroadenoma and one radial scar. The 32 not operated cases revealed to be benign or superimposition of normal parenchymal breast tissue. The cases were returned to biennial screening. Ultrasound did not show clearly any lesions, but using tomosynthesis and ultrasound together we were able to analyze and locate the lesions exactly. Special tomosynthesis improves overall lesion detection and analysis. The value of tomosynthesis and ultrasound fusion imaging will be to provide additional clinical information in order to improve decision making accuracy to either confirm or exclude a suspected abnormality and in particular detect small breast cancers.

  16. Clinical, electrophysiological and brain imaging features during recurrent ictal cortical blindness associated with chronic liver failure. (United States)

    van Pesch, V; Hernalsteen, D; van Rijckevorsel, K; Duprez, Th; Boschi, A; Ivanoiu, A; Sindic, C J M


    Transient neuroimaging features indicating primary cortical and secondary subcortical white matter cytotoxic oedema have been described in association with prolonged or intense seizures. We describe the unusual condition of recurrent ictal cortical blindness due to focal occipital status epilepticus, in the context of chronic hepatic failure. There was a close association between the onset and disappearance of clinical, electrophysiological and magnetic resonance imaging abnormalities.

  17. Clinical Utility of Amyloid Imaging in a Complex Case of Corticobasal Syndrome Presenting with Psychiatric Symptoms. (United States)

    Bensaïdane, M R; M-P, Fortin; Damasse, G; Chenard, M; Dionne, C; Duclos, M; Bouchard, R W; Laforce, R


    Clinical indications of amyloid imaging in atypical dementia remain unclear. We report a 68-year-old female without past psychiatric history who was hospitalized for auditory hallucinations and persecutory delusions associated with cognitive and motor deficits. Although psychotic symptoms resolved with antipsychotic treatment, cognitive and motor impairments remained. She further showed severe visuoconstructive and executive deficits, ideomotor apraxia, elements of Gerstmann's syndrome, bilateral agraphesthesia and discrete asymmetric motor deficits. Blood tests were unremarkable. Structural brain imaging revealed diffuse fronto-temporo-parietal atrophy, which was most severe in the parietal regions. Meanwhile, FDG-PET suggested asymmetrical fronto-temporo-parietal hypometabolism, with sparing of the posterior cingulate gyrus. A diagnosis of possible corticobasal syndrome (CBS) was made. Amyloid-PET using the novel tracer NAV4694 was ordered, and revealed significant deposition of fibrillar amyloid (SUVR 2.05). The primary diagnosis was CBS with underlying Alzheimer pathology and treatment with a cholinesterase inhibitor was initiated. Determination of underlying pathological CBS subtype is not simple even when based on extensive investigation including clinical presentation, atrophy patterns on MRI, and regional hypometabolism on FDG-PET. By contrast, amyloid imaging quickly confirmed Alzheimer pathology, and allowed rapid initiation of treatment in this complex case with early psychiatric symptoms. This case study illustrates the clinical utility of amyloid imaging in the setting of atypical cases seen in a tertiary memory clinic.

  18. The clinical and imaging presentation of acute "non complicated" pyelonephritis: A new profile for an ancient disease

    Directory of Open Access Journals (Sweden)

    Piccoli Giorgina


    Full Text Available Abstract Background Acute pyelonephritis (APN is differently defined according to imaging or clinical criteria. In adults information on the relationship between imaging and clinical data is lacking. Our study was aimed at analysing the relationship between the clinical and imaging presentation of APN, defined according to imaging criteria (parenchymal involvement at MR or CT scan. Methods All consecutive patients hospitalized for "non-complicated" APN were considered (June 2005-December 2009. Clinical, biochemical and imaging data at hospitalization were analyzed by univariate and logistic regression analysis. Results There were 119 patients, all females, median age 32 years (15-72. At hospitalization, inflammatory markers were elevated (CRP median: 12.1 mg/dL, normal Conclusions APN is a protean disease. In the absence of strict correlation with clinical or biochemical markers, imaging studies are required to assess the severity of kidney involvement.

  19. TU-E-BRB-00: Deformable Image Registration: Is It Right for Your Clinic

    Energy Technology Data Exchange (ETDEWEB)



    Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will also discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: Compare/contrast commercial DIR software and QA options Overview clinical DIR workflow for retreatment To understand uncertainties introduced by DIR Review TG-132 proposed recommendations.

  20. The image quality of ion computed tomography at clinical imaging dose levels

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, David C., E-mail: [Department of Experimental Clinical Oncology, Aarhus University Hospital, 8000 Aarhus (Denmark); Bassler, Niels [Department of Physics and Astronomy, Aarhus University, 8000 Aarhus (Denmark); Sørensen, Thomas Sangild [Department of Computer Science, Aarhus University, 8000 Aarhus, Denmark and Department of Clinical Medicine, Aarhus University, 8000 Aarhus (Denmark); Seco, Joao [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School,Boston, Massachusetts 02114 (United States)


    Purpose: Accurately predicting the range of radiotherapy ions in vivo is important for the precise delivery of dose in particle therapy. Range uncertainty is currently the single largest contribution to the dose margins used in planning and leads to a higher dose to normal tissue. The use of ion CT has been proposed as a method to improve the range uncertainty and thereby reduce dose to normal tissue of the patient. A wide variety of ions have been proposed and studied for this purpose, but no studies evaluate the image quality obtained with different ions in a consistent manner. However, imaging doses ion CT is a concern which may limit the obtainable image quality. In addition, the imaging doses reported have not been directly comparable with x-ray CT doses due to the different biological impacts of ion radiation. The purpose of this work is to develop a robust methodology for comparing the image quality of ion CT with respect to particle therapy, taking into account different reconstruction methods and ion species. Methods: A comparison of different ions and energies was made. Ion CT projections were simulated for five different scenarios: Protons at 230 and 330 MeV, helium ions at 230 MeV/u, and carbon ions at 430 MeV/u. Maps of the water equivalent stopping power were reconstructed using a weighted least squares method. The dose was evaluated via a quality factor weighted CT dose index called the CT dose equivalent index (CTDEI). Spatial resolution was measured by the modulation transfer function. This was done by a noise-robust fit to the edge spread function. Second, the image quality as a function of the number of scanning angles was evaluated for protons at 230 MeV. In the resolution study, the CTDEI was fixed to 10 mSv, similar to a typical x-ray CT scan. Finally, scans at a range of CTDEI’s were done, to evaluate dose influence on reconstruction error. Results: All ions yielded accurate stopping power estimates, none of which were statistically

  1. Clinical application of multimodality imaging in radiotherapy treatment planning for rectal cancer. (United States)

    Wang, Yan Yang; Zhe, Hong


    Radiotherapy plays an important role in the treatment of rectal cancer. Three-dimensional conformal radiotherapy and intensity-modulated radiotherapy are mainstay techniques of radiotherapy for rectal cancer. However, the success of these techniques is heavily reliant on accurate target delineation and treatment planning. Computed tomography simulation is a cornerstone of rectal cancer radiotherapy, but there are limitations, such as poor soft-tissue contrast between pelvic structures and partial volume effects. Magnetic resonance imaging and positron emission tomography (PET) can overcome these limitations and provide additional information for rectal cancer treatment planning. PET can also reduce the interobserver variation in the definition of rectal tumor volume. However, there is a long way to go before these image modalities are routinely used in the clinical setting. This review summarizes the most promising studies on clinical applications of multimodality imaging in target delineation and treatment planning for rectal cancer radiotherapy.

  2. MALDI mass spectrometry imaging of formalin-fixed paraffin-embedded tissues in clinical research. (United States)

    Gorzolka, Karin; Walch, Axel


    The molecular investigation of archived formalin-fixed, paraffin-embedded (FFPE) tissue samples provides the chance to obtain molecular patterns as indicatives for treatment and clinical end points. MALDI mass spectrometry imaging is capable of localizing molecules like proteins and peptides in tissue sections and became a favorite platform for the targeted and non-targeted approaches, especially in clinical investigations for biomarker research. In FFPE tissues the recovery of proteomic information is constrained by fixation-induced cross-links of proteins. The promising new insights obtained from FFPE in combination with the comprehensive patients' data caused much progress in the optimization of MS imaging protocols to investigate FFPE samples. This review presents the past and current research in MALDI MS imaging of FFPE tissues, demonstrating the improvement of analyses, their actual limitations, but also the promising future perspectives for histopathological and tissue-based research.

  3. Indications, advantages and limitations of perinatal postmortem imaging in clinical practice

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen J. [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom); Taylor, Andrew M. [Great Ormond Street Hospital for Children NHS Foundation Trust, Cardiorespiratory Division, London (United Kingdom); Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London (United Kingdom); Sebire, Neil J. [University College London, Institute of Child Health, London (United Kingdom); Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Histopathology, London (United Kingdom)


    Just as there is a range of paediatric imaging techniques available during life, a similar repertoire is available as part of the foetal and perinatal postmortem examination. In this article, we review the literature regarding the diagnostic utility of postmortem radiography, US, CT and MRI in this clinical setting. There is limited direct evidence on the diagnostic utility of any of these techniques, apart from postmortem MRI, which when combined with other noninvasive investigations, has been shown to be highly sensitive and specific for many foetal postmortem diagnoses. The main disadvantages of postmortem MRI include the longer duration of imaging, the need for appropriate training in the interpretation of normal postmortem changes, and possible non-diagnostic imaging examinations in early gestation fetuses. As less-invasive autopsy becomes increasingly available, the true utility of these techniques will evolve, and clinical guidelines for maximal diagnostic yield can be developed. (orig.)

  4. Lateral epicondylitis and beyond: imaging of lateral elbow pain with clinical-radiologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Kotnis, Nikhil A. [McMaster University, Departments of Radiology, Hamilton, ON (Canada); Sheffield Teaching Hospitals, Department of Medical Physics and Medical Imaging, Sheffield (United Kingdom); Chiavaras, Mary M. [McMaster University, Departments of Radiology, Hamilton, ON (Canada); Harish, Srinivasan [McMaster University, Departments of Radiology, Hamilton, ON (Canada); St. Joseph' s Healthcare, Department of Diagnostic Imaging, Hamilton, ON (Canada)


    The diagnosis of lateral epicondylitis is often straightforward and can be made on the basis of clinical findings. However, radiological assessment is valuable where the clinical picture is less clear or where symptoms are refractory to treatment. Demographics, aspects of clinical history, or certain physical signs may suggest an alternate diagnosis. Knowledge of the typical clinical presentation and imaging findings of lateral epicondylitis, in addition to other potential causes of lateral elbow pain, is necessary. These include entrapment of the posterior interosseous and lateral antebrachial cutaneous nerves, posterolateral rotatory instability, posterolateral plica syndrome, Panner's disease, osteochondritis dissecans of the capitellum, radiocapitellar overload syndrome, occult fractures and chondral-osseous impaction injuries, and radiocapitellar arthritis. Knowledge of these potential masquerades of lateral epicondylitis and their characteristic clinical and imaging features is essential for accurate diagnosis. The goal of this review is to provide an approach to the imaging of lateral elbow pain, discussing the relevant anatomy, various causes, and discriminating factors, which will allow for an accurate diagnosis. (orig.)

  5. Lateral epicondylitis and beyond: imaging of lateral elbow pain with clinical-radiologic correlation. (United States)

    Kotnis, Nikhil A; Chiavaras, Mary M; Harish, Srinivasan


    The diagnosis of lateral epicondylitis is often straightforward and can be made on the basis of clinical findings. However, radiological assessment is valuable where the clinical picture is less clear or where symptoms are refractory to treatment. Demographics, aspects of clinical history, or certain physical signs may suggest an alternate diagnosis. Knowledge of the typical clinical presentation and imaging findings of lateral epicondylitis, in addition to other potential causes of lateral elbow pain, is necessary. These include entrapment of the posterior interosseous and lateral antebrachial cutaneous nerves, posterolateral rotatory instability, posterolateral plica syndrome, Panner's disease, osteochondritis dissecans of the capitellum, radiocapitellar overload syndrome, occult fractures and chondral-osseous impaction injuries, and radiocapitellar arthritis. Knowledge of these potential masquerades of lateral epicondylitis and their characteristic clinical and imaging features is essential for accurate diagnosis. The goal of this review is to provide an approach to the imaging of lateral elbow pain, discussing the relevant anatomy, various causes, and discriminating factors, which will allow for an accurate diagnosis.

  6. Cross-sectional imaging for diagnosis and clinical outcome prediction of acute basilar artery thrombosis

    Energy Technology Data Exchange (ETDEWEB)

    Mortimer, A.M., E-mail: [Severn School of Radiology, Bristol (United Kingdom); Department of Radiology, Great Western Hospital, Swindon (United Kingdom); Saunders, T.; Cook, J.-L. [Department of Radiology, Great Western Hospital, Swindon (United Kingdom)


    Basilar artery occlusion is a potentially fatal condition and imaging findings can be subtle. Prompt diagnosis is vital, as recognition may lead to therapeutic recanalization that may improve functional outcome and survival. Furthermore, cross-sectional imaging signs may help predict eventual outcome and, therefore, guide which patients should be subjected to aggressive treatment. Computed tomography (CT) signs include a hyperdense basilar artery that has a high specificity, accuracy, positive and negative predictive value. Evidence regarding the prognostic significance of the hyperdense basilar artery sign is conflicting. Early magnetic resonance imaging (MRI) features include loss of flow void, seen as increased signal intensity within the basilar artery on T2-weigted images and identification of acute thrombus, seen as intermediate signal on T1-weighted images. MRI sequences are more sensitive for early detection of acute ischaemia or infarction, ideally with diffusion-weighted imaging (DWI). Both CT and MR angiography are sensitive for detection of acute thrombus, seen as a filling defect or occlusion. These are the non-invasive imaging techniques of choice to confirm diagnosis, with perhaps the speed and accessibility of CT angiography resulting in this technique being valuable in the acute setting. Several new scoring systems based on arterial segmentation rather than global volume assessment using CT angiography source images and DWI have shown early promise in the prediction of eventual clinical outcome in order to isolate those patients who may benefit from therapeutic recanalization.

  7. Clinical evaluation of {sup 99m}Tc-HMPAO labeled leukocyte imaging in ulcerative colitis

    Energy Technology Data Exchange (ETDEWEB)

    Saitoh, Yasuhiro; Aburano, Tamio; Takashio, Tetsuya; Shuke, Noriyuki; Ayabe, Tokiyoshi; Nomura, Masashi; Kohgo, Yutaka; Ishikawa, Yukio; Satoh, Junichi [Asahikawa Medical Coll., Hokkaido (Japan)


    Inflammatory imaging using {sup 99m}Tc-HMPAO-labeled mixed leukocytes was assessed for use in treating 11 cases diagnosed as ulcerative colitis: 10 cases with total colitis and 1 with left-sided colitis. They consisted of 8 patients with relapse-remitting type and 3 with chronic continuous type. Radionuclide abdominal images were obtained at 1 hr, 4 hr and 24 hr after intravenous injection of 200 MBq prepared {sup 99m}Tc leukocytes. Obvious colonic activity noted at 4 hr served as the basis for positive comparative criterion in the present study. The diagnostic efficacy of radionuclide imaging was compared with endoscopic findings (based on Matts` classification) and the clinical manifestations as reference. The sensitivity and specificity of this imaging were 83.3% and 85.7%, respectively, these values being consistent with endoscopic findings and clinical manifestations at sites of disease activity. All of positive images changed to negative after treatment by leukocyte apheresis or glucocorticoid. Based on these results, {sup 99m}Tc leukocyte imaging can be used to accurately evaluate severity and treatment response in ulcerative colitis. Leukocytes may be closely related to the pathogenesis of ulcerative colitis. (author)

  8. Analyzing the blood-brain barrier: the benefits of medical imaging in research and clinical practice. (United States)

    Chassidim, Yoash; Vazana, Udi; Prager, Ofer; Veksler, Ronel; Bar-Klein, Guy; Schoknecht, Karl; Fassler, Michael; Lublinsky, Svetlana; Shelef, Ilan


    A dysfunctional BBB is a common feature in a variety of brain disorders, a fact stressing the need for diagnostic tools designed to assess brain vessels' permeability in space and time. Biological research has benefited over the years various means to analyze BBB integrity. The use of biomarkers for improper BBB functionality is abundant. Systemic administration of BBB impermeable tracers can both visualize brain regions characterized by BBB impairment, as well as lead to its quantification. Additionally, locating molecular, physiological content in regions from which it is restricted under normal BBB functionality undoubtedly indicates brain pathology-related BBB disruption. However, in-depth research into the BBB's phenotype demands higher analytical complexity than functional vs. pathological BBB; criteria which biomarker based BBB permeability analyses do not meet. The involvement of accurate and engineering sciences in recent brain research, has led to improvements in the field, in the form of more accurate, sensitive imaging-based methods. Improvements in the spatiotemporal resolution of many imaging modalities and in image processing techniques, make up for the inadequacies of biomarker based analyses. In pre-clinical research, imaging approaches involving invasive procedures, enable microscopic evaluation of BBB integrity, and benefit high levels of sensitivity and accuracy. However, invasive techniques may alter normal physiological function, thus generating a modality-based impact on vessel's permeability, which needs to be corrected for. Non-invasive approaches do not affect proper functionality of the inspected system, but lack in spatiotemporal resolution. Nevertheless, the benefit of medical imaging, even in pre-clinical phases, outweighs its disadvantages. The innovations in pre-clinical imaging and the development of novel processing techniques, have led to their implementation in clinical use as well. Specialized analyses of vessels' permeability

  9. Intramuscular leukemic relapse: clinical signs and imaging findings. A multicentric analysis

    Energy Technology Data Exchange (ETDEWEB)

    Surov, Alexey [Martin Luther University Halle-Wittenberg, Department of Radiology, Halle (Germany); University of Leipzig, Department of Diagnostic and Interventional Radiology, Leipzig (Germany); Kiratli, Hayyam [Hacettepe University School of Medicine, Department of Ophthalmology, Ankara (Turkey); Im, Soo Ah [Seoul St. Mary' s Hospital, Department of Radiology, Seoul (Korea, Republic of); Manabe, Yasuhiro [National Hospital Organization Okayama Medical Center, Department of Neurology, Okayama (Japan); O' Neill, Alibhe; Shinagare, Atul B. [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Spielmann, Rolf Peter [Martin Luther University Halle-Wittenberg, Department of Radiology, Halle (Germany)


    Leukemia is a group of malignant diseases involving peripheral blood and bone marrow. Extramedullary tumor manifestation in leukemia can also occur. They more often involve lymph nodes, skin, and bones. Intramuscular leukemic relapse (ILR) is very unusual. The aim of this analysis was to summarize the reported data regarding clinical signs and radiological features of ILR. The PubMed database was searched for publications related to ILR. After an analysis of all identified articles, 20 publications matched the inclusion criteria. The authors of the 20 publications were contacted and provided imaging of their cases for review. The following were recorded: age, gender, primary diagnosis, clinical signs, pattern, localization and size of the intramuscular leukemic relapse. Images of 16 patients were provided [8 computer tomographic (CT) images and 15 magnetic resonance images, MRI]. Furthermore, one patient with ILR was identified in our institutional database. Therefore, images of 17 patients were available for further analysis. Overall, 32 cases with ILR were included in the analysis. In most cases acute myeloid leukemia was diagnosed. Most ILRs were localized in the extremities (44 %) and in the extraocular muscles (44 %). Clinically, ILR manifested as local pain, swelling and muscle weakness. Radiologically, ILR presented most frequently with diffuse muscle infiltration. On postcontrast CT/MRI, most lesions demonstrated homogeneous enhancement. ILRs were hypo-/isointense on T1w and hyperintense on T2w images. ILR manifests commonly as focal pain, swelling and muscle weakness. ILR predominantly involved the extraocular musculature and the extremities. Radiologically, diffuse muscle infiltration was the most common imaging finding. (orig.)

  10. Reliability and Validity Study of Clinical Ultrasound Imaging on Lateral Curvature of Adolescent Idiopathic Scoliosis.

    Directory of Open Access Journals (Sweden)

    Q Wang

    Full Text Available Non-ionizing radiation imaging assessment has been advocated for the patients with adolescent idiopathic scoliosis (AIS. As one of the radiation-free methods, ultrasound imaging has gained growing attention in scoliosis assessment over the past decade. The center of laminae (COL method has been proposed to measure the spinal curvature in the coronal plane of ultrasound image. However, the reliability and validity of this ultrasound method have not been validated in the clinical setting.To evaluate the reliability and validity of clinical ultrasound imaging on lateral curvature measurements of AIS with their corresponding magnetic resonance imaging (MRI measurements.Thirty curves (ranged 10.2°-68.2° from sixteen patients with AIS were eligible for this study. The ultrasound scan was performed using a 3-D ultrasound unit within the same morning of MRI examination. Two researchers were involved in data collection of these two examinations. The COL method was used to measure the coronal curvature in ultrasound image, compared with the Cobb method in MRI. The intra- and inter-rater reliability of the COL method was evaluated by intra-class correlation coefficient (ICC. The validity of this method was analyzed by paired Student's t-test, Bland-Altman statistics and Pearson correlation coefficient. The level of significance was set as 0.05.The COL method showed high intra- and inter-rater reliabilities (both with ICC (2, K >0.9, p0.9, p<0.05.The ultrasound imaging could provide a reliable and valid measurement of spinal curvature in the coronal plane using the COL method. Further research is needed to validate the proposed ultrasound measurement in larger clinical trial and to optimize the ultrasound scanning and measuring procedure.

  11. A longitudinal study of patients with cirrhosis treated with L-ornithine L-aspartate, examined with magnetization transfer, diffusion-weighted imaging and magnetic resonance spectroscopy


    Grover, Vijay P.B.; McPhail, Mark J W; Wylezinska-Arridge, Marzena; Crossey, Mary M E; Fitzpatrick, Julie A.; Southern, Louise; Saxby, Brian K.; Cook, Nicola A.; Cox, I. Jane; Waldman, Adam D.; Dhanjal, Novraj S.; Bak-Bol, Aluel; Williams, Roger; Morgan, Marsha Y; Taylor-Robinson, Simon D.


    The presence of overt hepatic encephalopathy (HE) is associated with structural, metabolic and functional changes in the brain discernible by use of a variety of magnetic resonance (MR) techniques. The changes in patients with minimal HE are less well documented. Twenty-two patients with well-compensated cirrhosis, seven of whom had minimal HE, were examined with cerebral 3 Tesla MR techniques, including T1- and T2-weighted, magnetization transfer and diffusion-weighted imaging and proton mag...

  12. [Contrast in static images in clinical magnetic resonance imaging. Part 2: Sequences for various contrast weightings and applications]. (United States)

    Schick, F


    The second part of this educational article focuses on sequence techniques in magnetic resonance imaging (MRI) and on suitable parameter sets for different contrast weightings. The content is based on the recently published part 1 of this educational article providing a survey on tissue properties relevant for most important contrast mechanisms. Characteristics of contrast weightings are presented in exemplary images recorded from healthy volunteers. Typical clinical applications of the most commonly used contrast weightings are described and discussed. Sequences for the following contrast weightings are included: proton density (density of hydrogen in small mobile molecules), relaxation times T1 and T2, chemical shift (water and fat), effects of magnetic susceptibility, restricted diffusion of water molecules and magnetization transfer between macromolecules and water molecules.

  13. Application of texture analysis to DAT SPECT imaging: Relationship to clinical assessments

    Directory of Open Access Journals (Sweden)

    Arman Rahmim


    Full Text Available Dopamine transporter (DAT SPECT imaging is increasingly utilized for diagnostic purposes in suspected Parkinsonian syndromes. We performed a cross-sectional study to investigate whether assessment of texture in DAT SPECT radiotracer uptake enables enhanced correlations with severity of motor and cognitive symptoms in Parkinson's disease (PD, with the long-term goal of enabling clinical utility of DAT SPECT imaging, beyond standard diagnostic tasks, to tracking of progression in PD. Quantitative analysis in routine DAT SPECT imaging, if performed at all, has been restricted to assessment of mean regional uptake. We applied a framework wherein textural features were extracted from the images. Notably, the framework did not require registration to a common template, and worked in the subject-native space. Image analysis included registration of SPECT images onto corresponding MRI images, automatic region-of-interest (ROI extraction on the MRI images, followed by computation of Haralick texture features. We analyzed 141 subjects from the Parkinson's Progressive Marker Initiative (PPMI database, including 85 PD and 56 healthy controls (HC (baseline scans with accompanying 3 T MRI images. We performed univariate and multivariate regression analyses between the quantitative metrics and different clinical measures, namely (i the UPDRS (part III - motor score, disease duration as measured from (ii time of diagnosis (DD-diag. and (iii time of appearance of symptoms (DD-sympt., as well as (iv the Montreal Cognitive Assessment (MoCA score. For conventional mean uptake analysis in the putamen, we showed significant correlations with clinical measures only when both HC and PD were included (Pearson correlation r = −0.74, p-value < 0.001. However, this was not significant when applied to PD subjects only (r = −0.19, p-value = 0.084, and no such correlations were observed in the caudate. By contrast, for the PD subjects, significant correlations

  14. Image workstation in a medical intensive care unit changes viewing patterns and timing of image-based clinical actions in routine portable chest radiographs (United States)

    Redfern, Regina O.; Kundel, Harold L.; Polansky, Marcia; Langlotz, Curtis P.; Lanken, Paul N.; Brikman, Inna; Horii, Steven C.; Bozzo, Mary T.; Feingold, Eric R.; Nodine, Calvin F.


    In order to determine the effect of an image workstation, viewing patterns and related clinical actions were evaluated in a randomized prospective study. During 16 weeks of Computed Radiography data collection, an image workstation was conveniently available to the Medical Intensive Care Unit clinicians. The workstation was not available for clinical use during 16 weeks of Analog Film data collection. Viewing patterns were evaluated by comparing viewing times. Patient care was evaluated by comparing the time of performing image based clinical actions. The percentage of routine exams viewed before AM Radiology Conference increased from 0% during the Analog Periods to 27% during the CR PACS Periods. Clinicians selected images taken during the first few days of the patient's admission for viewing before conference. Images taken later in admission were viewed during or after conference. On days when radiology conference was not held, images were viewed significantly earlier when the workstation was available. Clinical actions based on images viewed on the workstation were performed significantly earlier. When an image workstation was available routine images were viewed sooner and image based actions occurred earlier.

  15. Clinical multi-colour fluorescence imaging of malignant tumours - initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Svanberg, K.; Wang, I. [Lund Univ. Hospital (Sweden). Lund Medical Laser Centre]|[Lund Univ. Hospital (Sweden). Dept. of Oncology; Colleen, S. [Lund Univ. Hospital (Sweden). Lund Medical Laser Centre]|[Lund Univ. Hospital (Sweden). Dept. of Urology; Idvall, I. [Lund Univ. Hospital (Sweden). Lund Medical Laser Centre]|[Lund Univ. Hospital (Sweden). Dept. of Pathology; Ingvar, C. [Lund Univ. Hospital (Sweden). Lund Medical Laser Centre]|[Lund Univ. Hospital (Sweden). Dept. of Surgery; Rydell, R. [Lund Univ. Hospital (Sweden). Lund Medical Laser Centre]|[Lund Univ. Hospital (Sweden). Dept. of Oto-Rhino-Laryngology; Jocham, D. [Luebeck Univ. (Germany). Abt. fuer Urologie; Diddens, H. [Luebeck Univ. (Germany). Medizinisches Laser Zentrum; Bown, S.; Gregory, G. [National Medical Laser Centre, Dept. of Surgery, Rayne Inst., London (United Kingdom); Montan, S. [Spectraphos AB, Ideon, Lund (Sweden); Andersson-Engels, S.; Svanberg, S. [Lund Univ. Hospital (Sweden). Lund Medical Laser Centre]|[Lund Inst. of Technology (Sweden). Dept. of Physics


    The purpose of this study was to present a new technique for non-invasive tumour detection based on tissue fluorescence imaging. A clinically adapted multi-colour fluorescence system was employed in the real-time imaging of malignant tumours of the skin, breast, head and neck region, and urinary bladder. Tumour detection was based on the contrast displayed in fluorescence between normal and malignant tissue, related to the selective uptake of tumour-marking agents and natural chromophore differences between various tissues. In order to demarcate basal cell carcinomas of the skin, ALA was applied topically 4-6 h before the fluorescence investigation. For urinary bladder tumour visualisation, ALA was instilled into the bladder 1-2 h prior to the study. Malignant and premalignant lesions in the head and neck region were imaged after i.v. injection of HPD (Photofrin). The tumour imaging system was coupled to an endoscope. Fluorescence light emission from the tissue surface was induced with 100-ns-long optical pulses at 390 nm, generated from a frequency-doubled alexandrite laser. With the use of special image-splitting optics, the tumour fluorescence, intensified in a micro-channel plate, was imaged in 3 selected wavelength bands. These 3 images were processed together to form a new optimised-contrast image of the tumour. This image, updated at a rate of about 3 frames/s was mixed with a normal colour video image of the tissue. A clear demarcation from normal surrounding tissue was found during in vivo measurements of superficial bladder carcinoma, basal cell carcinoma of the skin, and leukoplakia with dysplasia of the lip, and in vitro investigations of resected breast cancer. (orig./MG).

  16. Validation of radiocarpal joint contact models based on images from a clinical MRI scanner. (United States)

    Johnson, Joshua E; McIff, Terence E; Lee, Phil; Toby, E Bruce; Fischer, Kenneth J


    This study was undertaken to assess magnetic resonance imaging (MRI)-based radiocarpal surface contact models of functional loading in a clinical MRI scanner for future in vivo studies, by comparison with experimental measures from three cadaver forearm specimens. Experimental data were acquired using a Tekscan sensor during simulated light grasp. Magnetic resonance (MR) images were used to obtain model geometry and kinematics (image registration). Peak contact pressures (PPs) and average contact pressures (APs), contact forces and contact areas were determined in the radiolunate and radioscaphoid joints. Contact area was also measured directly from MR images acquired with load and compared with model data. Based on the validation criteria (within 25% of experimental data), out of the six articulations (three specimens with two articulations each), two met the criterion for AP (0%, 14%); one for peak pressure (20%); one for contact force (5%); four for contact area with respect to experiment (8%, 13%, 19% and 23%), and three contact areas met the criterion with respect to direct measurements (14%, 21% and 21%). Absolute differences between model and experimental PPs were reasonably low (within 2.5 MPa). Overall, the results indicate that MRI-based models generated from 3T clinical MR scanner appear sufficient to obtain clinically relevant data.

  17. Disease activity in Graves' ophthalmopathy: diagnosis with orbital MR imaging and correlation with clinical score. (United States)

    Tortora, Fabio; Cirillo, Mario; Ferrara, Marco; Belfiore, Maria Paola; Carella, Carlo; Caranci, Ferdinando; Cirillo, Sossio


    In Graves' ophthalmopathy (GO) it is important to distinguish acute inflammation at an early stage, responsive to immunosuppressive treatment, from inactive fibrotic end stage disease, unresponsive to the same treatment. The purpose of this study was to identify the most relevant signal intensities on orbital MR imaging with contrast administration both to classify patients according to their clinical activity score (defined by a cut-off value of 3) and to make a prediction of patient's CAS. Such threshold was considered as widely used in literature. Sixteen consecutive patients with a diagnosis of GO in different phases of thyroid disease based on clinical and orbital MR imaging signs, and six normal volunteers were examined. Orbital MR imaging was performed on a 1.5 Tesla MR Unit. MR scans were assessed by an experienced neuroradiologist, blinded to the clinical examinations. We found a statistical correlation between CAS and both STIR and contrast enhanced T1-weighted sequences. There was also a statistically significant correlation between STIR and contrast-enhanced T1 images disclosing the possibility of avoiding the injection of contrast medium. Our study proved that signal intensity values on STIR sequence increase in the inflammatory oedematous phase of disease. We confirmed the correlation between signal intensities on this sequence and CAS, showing an increase in signal intensity proportional to the CAS value. So we validated MRI use to establish the activity phase of disease more sensitively than CAS alone.

  18. Disease Activity in Graves' Ophthalmopathy: Diagnosis with Orbital MR Imaging and Correlation with Clinical Score (United States)

    Tortora, Fabio; Cirillo, Mario; Ferrara, Marco; Belfiore, Maria Paola; Carella, Carlo; Caranci, Ferdinando; Cirillo, Sossio


    Summary In Graves' ophthalmopathy (GO) it is important to distinguish acute inflammation at an early stage, responsive to immunosuppressive treatment, from inactive fibrotic end stage disease, unresponsive to the same treatment. The purpose of this study was to identify the most relevant signal intensities on orbital MR imaging with contrast administration both to classify patients according to their clinical activity score (defined by a cut-off value of 3) and to make a prediction of patient's CAS. Such threshold was considered as widely used in literature. Sixteen consecutive patients with a diagnosis of GO in different phases of thyroid disease based on clinical and orbital MR imaging signs, and six normal volunteers were examined. Orbital MR imaging was performed on a 1.5 Tesla MR Unit. MR scans were assessed by an experienced neuroradiologist, blinded to the clinical examinations. We found a statistical correlation between CAS and both STIR and contrast enhanced T1-weighted sequences. There was also a statistically significant correlation between STIR and contrast-enhanced T1 images disclosing the possibility of avoiding the injection of contrast medium. Our study proved that signal intensity values on STIR sequence increase in the inflammatory oedematous phase of disease. We confirmed the correlation between signal intensities on this sequence and CAS, showing an increase in signal intensity proportional to the CAS value. So we validated MRI use to establish the activity phase of disease more sensitively than CAS alone. PMID:24199816

  19. Dynamic MR imaging of internal derangements of the temporomandibular joint: correlation with clinical signs and symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Ah; Chun, Eun Ju; Kim, Yoo Kyung; Yoo, Jeong Hyun; Choi, Hae Young; Kim, Hyun Jin [Ewha Womans Univ. College of Medicine, Seoul (Korea, Republic of); Chung, Eun Chul [Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of)


    To evaluate the correlation between findings of dynamic magnetic resonance (MR) imaging of the temporomandibular joint (TMJ) and clinical findings in patients with internal derangement of the TMJ. Dynamic MR images of 130 joints of 65 patients (17 men and 48 women aged 14 to 74; mean age, 34) with internal derangement of the TMJ were obtained using a 1.5-T MR imaging system. MR findings of anterior displacement, disc deformity and degenerative change were correlated with clinical findings including joint pain, clicking sound, crepitation and maximal mouth opening (MMO). Among 62 joints with TMJ pain, 32 showed anterior displacement without reduction, 15 showed disc deformity and 19 showed degenerative change. Among 49 joints in which there was a clicking sound, 24, 8 and 12 joints, respectively, showed the above-mentioned findings, while in seven with crepitation, these same findings were evident in five, six and four joints, respectively. Bilateral and unilateral joint disorders were observed in 17 and five patients, respectively, among 22 with MMO less than 30mm and in 11 and 18 of 42 patients with MMO between 30mm and 60mm. On MR imaging, patients with MMO less than 30mm usually showed bilateral joint disorders and those with crepitation showed chronic change. This indicates that there is high association between clinical findings of internal derangement of TMJ and MR findings.

  20. Integrated support for medical image analysis methods: from development to clinical application. (United States)

    Olabarriaga, Sílvia D; Snel, Jeroen G; Botha, Charl P; Belleman, Robert G


    Computer-aided image analysis is becoming increasingly important to efficiently and safely handle large amounts of high-resolution images generated by advanced medical imaging devices. The development of medical image analysis (MIA) software with the required properties for clinical application, however, is difficult and labor-intensive. Such development should be supported by systems providing scalable computational capacity and storage space, as well as information management facilities. This paper describes the properties of distributed systems to support and facilitate the development, evaluation, and clinical application of MIA methods. First, the main characteristics of existing systems are presented. Then, the phases in a method's lifecycle are analyzed (development, parameter optimization, evaluation, clinical routine), identifying the types of users, tasks, and related computational issues. A scenario is described where all tasks are performed with the aid of computational tools integrated into an ideal supporting environment. The requirements for this environment are described, proposing a grid-oriented paradigm that emphasizes virtual collaboration among users, pieces of software, and devices distributed among geographically dispersed healthcare, research, and development enterprises. Finally, the characteristics of the existing systems are analyzed according to these requirements. The proposed requirements offer a useful framework to evaluate, compare, and improve the existing systems that support MIA development.

  1. Wernicke encephalopathy Clinical presentation and MR images in two nonalcoholic patients

    Institute of Scientific and Technical Information of China (English)

    He Zhang; Jun Wu; Zhiping Hu; Bo Xiao; Guoliang Li


    The aim of the present study was to investigate the importance of and correlation between clinical presentations and magnetic resonance imaging (MRI) of two different cases of nonalcoholic Wernicke encephalopathy. Case 1: A 63-year-old man with a diagnosis of incomplete mechanical intestinal obstruction. His abdominal symptoms were improved by gastrointestinal decompression, but blurred vision, hypoacusis, dizziness, and unsteady gait were noted. His illness deteriorated to confusion on day seven. MRI showed hyperintense lesions in the medial thalami, tectum of the midbrain, and the periaqueduct region on T2- and diffusion-weighted images. Thiamine therapy was commenced immediately with good results. Case 2: A 22-year-old woman was admitted for sudden-onset confabulation and unsteady gait after hyperemesis gravidarum. She had no history of alcohol or any medication. Brain MRI was normal. The patient experienced relief after Vitamin B1 treatment. These results suggest that brain MRI can define characteristic abnormalities in Wernicke encephalopathy, and that diffusion-weighted imaging may improve the diagnosis sensitivity. In addition, the MRI images may be correlated to the clinical stage and severity of the disease. Nevertheless, the clinical features are essential for correct diagnosis.

  2. Bioluminescent imaging: a critical tool in pre-clinical oncology research.

    LENUS (Irish Health Repository)

    O'Neill, Karen


    Bioluminescent imaging (BLI) is a non-invasive imaging modality widely used in the field of pre-clinical oncology research. Imaging of small animal tumour models using BLI involves the generation of light by luciferase-expressing cells in the animal following administration of substrate. This light may be imaged using an external detector. The technique allows a variety of tumour-associated properties to be visualized dynamically in living models. The increasing use of BLI as a small-animal imaging modality has led to advances in the development of xenogeneic, orthotopic, and genetically engineered animal models expressing luciferase genes. This review aims to provide insight into the principles of BLI and its applications in cancer research. Many studies to assess tumour growth and development, as well as efficacy of candidate therapeutics, have been performed using BLI. More recently, advances have also been made using bioluminescent imaging in studies of protein-protein interactions, genetic screening, cell-cycle regulators, and spontaneous cancer development. Such novel studies highlight the versatility and potential of bioluminescent imaging in future oncological research.

  3. Magnetic resonance imaging in perinatal brain injury: clinical presentation, lesions and outcome

    Energy Technology Data Exchange (ETDEWEB)

    Rutherford, Mary; Ward, Phil; Allsop, Joanna; Counsell, Serena [Imperial College London, Hammersmith Hospital, Robert Steiner MR Unit, Imaging Sciences Department, Clinical Sciences Centre, London (United Kingdom); Srinivasan, Latha; Dyet, Leigh; Cowan, Frances [Imperial College, Hammersmith Hospital, Department of Paediatrics, Imaging Sciences Department, Clinical Sciences Centre, London (United Kingdom)


    Neonatal MR imaging is invaluable in assessing the term born neonate who presents with an encephalopathy. Successful imaging requires adaptations to both the hardware and the sequences used for adults. The perinatal and postnatal details often predict the pattern of lesions sustained and are essential for correct interpretation of the imaging findings, but additional or alternative diagnoses in infants with apparent hypoxic ischaemic encephalopathy should always be considered. Perinatally acquired lesions are usually at their most obvious between 1 and 2 weeks of age. Very early imaging (<3 days) may be useful to make management decisions in ventilated neonates, but abnormalities may be subtle at that stage. Diffusion-weighted imaging is clinically useful for the early identification of ischaemic white matter in the neonatal brain but is less reliable in detecting lesions within the basal ganglia and thalami. The pattern of lesions seen on MRI can predict neurodevelopmental outcome. Additional useful information may be obtained by advanced techniques such as MR angiography, venography and perfusion-weighted imaging. Serial imaging with quantification of both structure size and tissue damage provides invaluable insights into perinatal brain injury. (orig.)

  4. PET imaging with ⁸⁹Zr: from radiochemistry to the clinic. (United States)

    Deri, Melissa A; Zeglis, Brian M; Francesconi, Lynn C; Lewis, Jason S


    The advent of antibody-based cancer therapeutics has led to the concomitant rise in the development of companion diagnostics for these therapies, particularly nuclear imaging agents. A number of radioisotopes have been employed for antibody-based PET and SPECT imaging, notably ⁶⁴Cu, ¹²⁴I, ¹¹¹In, and (99m)Tc; in recent years, however, the field has increasingly focused on ⁸⁹Zr, a radiometal with near ideal physical and chemical properties for immunoPET imaging. In the review at hand, we seek to provide a comprehensive portrait of the current state of ⁸⁹Zr radiochemical and imaging research, including work into the production and purification of the isotope, the synthesis of new chelators, the development of new bioconjugation strategies, the creation of novel ⁸⁹Zr-based agents for preclinical imaging studies, and the translation of ⁸⁹Zr-labeled radiopharmaceuticals to the clinic. Particular attention will also be dedicated to emerging trends in the field, ⁸⁹Zr-based imaging applications using vectors other than antibodies, the comparative advantages and limitations of ⁸⁹Zr-based imaging compared to that with other isotopes, and areas that would benefit from more extensive investigation. At bottom, it is hoped that this review will provide both the experienced investigator and new scientist with a full and critical overview of this exciting and fast-developing field.

  5. Will imaging of apoptosis play a role in clinical care? A tale of mice and men. (United States)

    Blankenberg, F G; Strauss, H W


    Programmed cell death (apoptosis) plays a role in the pathophysiology of many diseases and in the outcome of treatment. Apoptosis is the likely mechanism behind the cytoreductive effects of standard chemotherapeutic and radiation treatments, rejection of organ transplants, cellular damage in collagen vascular disorders, and delayed cell death due to hypoxic-ischemic injury in myocardial infarction and neonatal hypoxic ischemic injury. Observations about the role of apoptosis have fueled the development of novel agents and treatment strategies specifically aimed at inducing or inhibiting apoptosis. Despite these research developments there are no clinical entities where specific measures of apoptosis are used in either diagnosis or patient management. Part of the difficulty in bridging the gap between the basic science understanding of apoptosis and the clinical application of this information is the lack of a sensitive marker to monitor programmed cell death in association with disease progression or regression. Technetium-99m labeled annexin V localizes at sites of apoptosis in-vivo, due to its nanomolar affinity for membrane bound phosphatidylserine. Radiolabeled annexin V imaging permits identification of the site and extent of apoptosis in experimental animals. Annexin V has been successfully used in animal models to image organ transplant rejection, characterize successful therapy of tumors, pinpoint acute myocardial infarction, and identify hypoxic ischemic brain injury of the newborn and adult. Early studies in human subjects suggest that 99mTc annexin imaging will be also be useful to identify rejection in transplant recipients, localize acute myocardial infarction, and characterize the effectiveness of a single treatment in patients with tumors. This review describes the imaging approaches to detect and monitor apoptosis in-vivo that are presently in early clinical trials. The preliminary data are extrapolated to identify conditions where apoptosis imaging

  6. Myocardial strain imaging: how useful is it in clinical decision making? (United States)

    Smiseth, Otto A; Torp, Hans; Opdahl, Anders; Haugaa, Kristina H; Urheim, Stig


    Myocardial strain is a principle for quantification of left ventricular (LV) function which is now feasible with speckle-tracking echocardiography. The best evaluated strain parameter is global longitudinal strain (GLS) which is more sensitive than left ventricular ejection fraction (LVEF) as a measure of systolic function, and may be used to identify sub-clinical LV dysfunction in cardiomyopathies. Furthermore, GLS is recommended as routine measurement in patients undergoing chemotherapy to detect reduction in LV function prior to fall in LVEF. Intersegmental variability in timing of peak myocardial strain has been proposed as predictor of risk of ventricular arrhythmias. Strain imaging may be applied to guide placement of the LV pacing lead in patients receiving cardiac resynchronization therapy. Strain may also be used to diagnose myocardial ischaemia, but the technology is not sufficiently standardized to be recommended as a general tool for this purpose. Peak systolic left atrial strain is a promising supplementary index of LV filling pressure. The strain imaging methodology is still undergoing development, and further clinical trials are needed to determine if clinical decisions based on strain imaging result in better outcome. With this important limitation in mind, strain may be applied clinically as a supplementary diagnostic method.

  7. Preclinical Evaluation of Raman Nanoparticle Biodistribution for their Potential Use in Clinical Endoscopy Imaging

    DEFF Research Database (Denmark)

    Zavaleta, Cristina L; Hartman, Keith B; Miao, Zheng


    Raman imaging offers unsurpassed sensitivity and multiplexing capabilities. However, its limited depth of light penetration makes direct clinical translation challenging. Therefore, a more suitable way to harness its attributes in a clinical setting would be to couple Raman spectroscopy with endo......Raman imaging offers unsurpassed sensitivity and multiplexing capabilities. However, its limited depth of light penetration makes direct clinical translation challenging. Therefore, a more suitable way to harness its attributes in a clinical setting would be to couple Raman spectroscopy...... with endoscopy. The use of an accessory Raman endoscope in conjunction with topically administered tumor-targeting Raman nanoparticles during a routine colonoscopy could offer a new way to sensitively detect dysplastic lesions while circumventing Raman's limited depth of penetration and avoiding systemic...... toxicity. In this study, the natural biodistribution of gold surface-enhanced Raman scattering (SERS) nanoparticles is evaluated by radiolabeling them with (64) Cu and imaging their localization over time using micropositron emission tomography (PET). Mice are injected either intravenously (IV...

  8. Development of X-ray dark-field imaging towards clinical application

    Institute of Scientific and Technical Information of China (English)



    Review of X-ray dark-field imaging under development is presented. Its goal is its application to clinical diagnosis of organs that have been invisible by the ordinary techniques. In order to clinically visualize tissues in detail one needs high contrast and high spatial resolution say ~50 μm. This X-ray optics comprises a Bragg asymmetric monochro-collimator and a Bragg case or a Laue case filter with capability of analyzing angle in a parallel position. Their diffraction index is 4,4,0 and the X-ray energy 35 keV (λ= 0.0354 nm). The filter has 0.6 mm thickness in the Bragg case or 1.075 mm or 2.15 mm thickness in the Laue case. Under this condition only the refracted X-rays from object can transmit through the filter while the beam that may receive absorption and/or phase change will not. Soft tissues at human joints thus taken show high contrast images so that the DFI is promising for clinical diagnosis. Preliminary X-ray absorption images of another clinical candidates of ear bones are also shown.

  9. Cervical spine degenerative diseases: An evaluation of clinical and imaging features in surgical decisions

    Energy Technology Data Exchange (ETDEWEB)

    Soo, M.; Tran-Dinh, H.D.; Quach, T.; Downey, J.; Pohlmann, S. [Westmead Hospital, Westmead, NSW (Australia). Department of Radiology; Dorsch, N.W.C. [Westmead Hospital, Westmead, NSW (Australia). Department of Neurosurgery


    In clinically severe cervical spondylosis, imaging plays a vital role in surgical decisions. A prime factor is acquired canal stenosis with cord compression. To validate this concept, the clinical and imaging features of 20 patients with spondylitic myelopathy and 24 with radiculopathy were retrospectively reviewed. All had computed tomographic myelography (CTM) as part of their clinical work-up. The patients` clinical severity was graded as mild, moderate and severe; the age, length of illness and a history of eventual surgery or otherwise were recorded. At the level of maximum compression the following parameters were obtained from the axial CTM images: surface area and ratio of the anteroposterior to the transverse diameter of the cord; subarachnoid space and vertebral canal areas. Data were statistically analysed. A significant association exists between surgery and increasing severity of symptoms (P=0.04), and advancing age (P=0.01). These associations hold true for myelopathy and radiculopathy. A strong association is present between surgery and the surface area of the cord (P=0.01), being applicable to myelopathy only. The other parameters show no association with surgical decisions. It is concluded that with myelopathy a narrow cord area at the level of maximum compression, and moderate-severe functional impairment are indicators for surgical intervention. (authors). 22 refs., 3 tabs., 3 figs.

  10. Three dimensional first-pass myocardial perfusion imaging at 3T: feasibility study

    Directory of Open Access Journals (Sweden)

    Pohost Gerald M


    Full Text Available Abstract Background In patients with ischemic heart disease, accurate assessment of the extent of myocardial perfusion deficit may be important in predicting prognosis of clinical cardiac outcomes. The aim of this study was to compare the ability of three dimensional (3D and of two dimensional (2D multi-slice myocardial perfusion imaging (MPI using cardiovascular magnetic resonance (CMR in determining the size of defects, and to demonstrate the feasibility of 3D MPI in healthy volunteers at 3 Tesla. Methods A heart phantom was used to compare the accuracy of 3D and 2D multi-slice MPI in estimating the volume fraction of seven rubber insets which simulated transmural myocardial perfusion defects. Three sets of cross-sectional planes were acquired for 2D multi-slice imaging, where each set was shifted along the partition encoding direction by ± 10 mm. 3D first-pass contrast-enhanced (0.1 mmol/kg Gd-DTPA MPI was performed in three volunteers with sensitivity encoding for six-fold acceleration. The upslope of the myocardial time-intensity-curve and peak SNR/CNR values were calculated. Results Mean/standard deviation of errors in estimating the volume fraction across the seven defects were -0.44/1.49%, 2.23/2.97%, and 2.59/3.18% in 3D, 2D 4-slice, and 2D 3-slice imaging, respectively. 3D MPI performed in healthy volunteers produced excellent quality images with whole left ventricular (LV coverage. Peak SNR/CNR was 57.6 ± 22.0/37.5 ± 19.7 over all segments in the first eight slices. Conclusion 3D performed better than 2D multi-slice MPI in estimating the size of perfusion defects in phantoms. Highly accelerated 3D MPI at 3T was feasible in volunteers, allowing whole LV coverage with excellent image quality and high SNR/CNR.

  11. A versatile knowledge-based clinical imaging annotation system for breast cancer screening (United States)

    Gemo, Monica; Gouze, Annabelle; Debande, Benoît; Grivegnée, André; Mazy, Gilbert; Macq, Benoît


    Medical information is evolving towards more complex multimedia data representation, as new imaging modalities are made available by sophisticated devices. Features such as segmented lesions can now be extracted through analysis techniques and need to be integrated into clinical patient data. The management of structured information extracted from multimedia has been addressed in knowledge based annotation systems providing methods to attach interpretative semantics to multimedia content. Building on these methods, we develop a new clinical imaging annotation system for computer aided breast cancer screening. The proposed system aims at more consistent, efficient and standardised data mark-up of digital and digitalised radiology images. The objective is to provide detailed characterisation of abnormalities as an aid in the diagnostic task through integrated annotation management. The system combines imaging analysis results and radiologist diagnostic information about suspicious findings by mapping well-established visual and low-level descriptors into pathology specific profiles. The versatile characterisation allows differentiating annotation descriptors for different types of findings. Our approach of semi-automatic integrated annotations supports increased quality assurance in screening practice. This is achieved through detailed and objective patient imaging information while providing user-friendly means for their manipulation that is oriented to relieving the radiologist's workload.

  12. Clinical evaluation of PET image reconstruction using a spatial resolution model

    DEFF Research Database (Denmark)

    Andersen, Flemming Littrup; Klausen, Thomas Levin; Loft, Annika;


    PURPOSE: PET image resolution is variable across the measured field-of-view and described by the point spread function (PSF). When accounting for the PSF during PET image reconstruction image resolution is improved and partial volume effects are reduced. Here, we evaluate the effect of PSF......-based reconstruction on lesion quantification in routine clinical whole-body (WB) PET/CT imaging. MATERIALS AND METHODS: 41 oncology patients were referred for a WB-PET/CT examination (Biograph 40 TruePoint). Emission data were acquired at 2.5min/bed at 1hpi of 400 MBq [18F]-FDG. Attenuation-corrected PET images were...... of view (FOV). There was no significant difference in SUV(mean) in homogenous liver tissue between R1 and R2. CONCLUSION: In whole-body FDG-PET/CT using routine clinical protocols, PSF-based PET reconstruction increases lesion detection and affects SUV(max) measurements compared to standard AW-OSEM PET...

  13. X-ray dark field imaging of human articular cartilage: Possible clinical application to orthopedic surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kunisada, Toshiyuki [Department of Medical Materials for Musculoskeletal Reconstruction, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558 (Japan); Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558 (Japan)], E-mail:; Shimao, Daisuke [Department of Radiological Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki 300-2394 (Japan); Sugiyama, Hiroshi [Photon Factory, Institute of Materials Structure Science, High Energy Accelerator Research Organization (KEK), Ibaraki 305-0801 (Japan); Takeda, Ken; Ozaki, Toshifumi [Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558 (Japan); Ando, Masami [Research Institute for Science and Technology, Tokyo University of Science, Chiba 278-8510 (Japan)


    Despite its convenience and non-invasiveness on daily clinical use, standard X-ray radiography cannot show articular cartilage. We developed a novel type of X-ray dark field imaging (DFI), which forms images only by a refracted beam with very low background illumination. We examined a disarticulated distal femur and a shoulder joint with surrounding soft tissue and skin, both excised from a human cadaver at the BL20B2 synchrotron beamline at SPring-8. The field was 90 mm wide and 90 mm high. Articular cartilage of the disarticulated distal femur was obvious on DFI, but not on standard X-ray images. Furthermore, DFI allowed visualization in situ of articular cartilage of the shoulder while covered with soft tissue and skin. The gross appearance of the articular cartilage on the dissected section of the proximal humerus was identical to the cartilage shown on the DFI image. These results suggested that DFI could provide a clinically accurate method of assessing articular cartilage. Hence, DFI would be a useful imaging tool for diagnosing joint disease such as osteoarthritis.

  14. Congenital portosystemic shunts: Imaging findings and clinical presentations in 11 patients

    Energy Technology Data Exchange (ETDEWEB)

    Konstas, Angelos A., E-mail: [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Boston, MA 02114 (United States); Digumarthy, Subba R.; Avery, Laura L. [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Boston, MA 02114 (United States); Wallace, Karen L. [Department of Radiology, Mount Auburn Hospital and Harvard Medical School, 330 Mount Auburn St, Cambridge, MA 02138 (United States); Lisovsky, Mikhail; Misdraji, Joseph [Department of Pathology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Boston, MA 02114 (United States); Hahn, Peter F. [Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Boston, MA 02114 (United States)


    Objective: To evaluate the clinical anatomy and presentations of congenital portosystemic shunts, and determine features that promote recognition on imaging. Materials and methods: Institutional review board approval was obtained for this HIPAA-compliant study. The requirement for written informed consent was waived. Radiology reports were retrospectively reviewed from non-cirrhotic patients who underwent imaging studies from January 1999 through February 2009. Clinical sources reviewed included electronic medical records, archived images and histopathological material. Results: Eleven patients with congenital portosystemic shunts were identified (six male and five female; age range 20 days to 84 years). Seven patients had extrahepatic and four patients had intrahepatic shunts. All 11 patients had absent or hypoplastic intrahepatic portal veins, a feature detected by CT and MRI, but not by US. Seven patients presented with shunt complications and four with presentations unrelated to shunt pathophysiology. Three adult patients had four splenic artery aneurysms. Prospective radiological evaluation of five adult patients with cross-sectional imaging had failed prospectively to recognize the presence of congenital portosystemic shunts on one or more imaging examinations. Conclusions: Congenital portosystemic shunts are associated with splenic artery aneurysms, a previously unrecognized association. Portosystemic shunts were undetected during prospective radiologic evaluation in the majority of adult patients, highlighting the need to alert radiologists to this congenital anomaly.

  15. Clinical study of ex vivo photoacoustic imaging in endoscopic mucosal resection tissues (United States)

    Lim, Liang; Streutker, Catherine J.; Marcon, Norman; Cirocco, Maria; Lakovlev, Vladimir V.; DaCosta, Ralph; Foster, F. S.; Wilson, Brian C.


    Accurate endoscopic detection and dysplasia in patients with Barrett's esophagus (BE) remains a major unmet clinical need. Current diagnosis use multiple biopsies under endoscopic image guidance, where up to 99% of the tissue remains unsampled, leading to significant risk of missing dysplasia. We conducted an ex vivo clinical trial using photoacoustic imaging (PAI) in patients undergoing endoscopic mucosal resection (EMR) with known high-grade dysplasia for the purpose of characterizing the esophageal microvascular pattern, with the long-term goal of performing in vivo endoscopic PAI for dysplasia detection and therapeutic guidance. EMR tissues were mounted immediately on an agar layer and covered with ultrasound gel. Digital photography guided the placement of the PAI transducer (40 MHz center frequency). The luminal side of the specimen was scanned over a field of view of 14 mm (width) by 15 mm (depth) at 680, 750, 824, 850 and 970 nm. Acoustic images were simultaneously acquired. Tissues were then sliced and fixed in formalin for histopathology with H and E staining. Analysis consisted of co-registration and correlation between the intrinsic PAI features and the histological images. The initial PAI + ultrasound images from 8 BE patients have demonstrated the technical feasibility of this approach and point to the potential of PAI to reveal the microvascular pattern within EMR specimens. There are several technical factors to be considered in rigorous interpretation of the PAI characteristics, including the loss of blood from the ex vivo specimens and the limited depth penetration of the photoacoustic signal.

  16. A compact microscope setup for multimodal nonlinear imaging in clinics and its application to disease diagnostics. (United States)

    Meyer, Tobias; Baumgartl, Martin; Gottschall, Thomas; Pascher, Torbjörn; Wuttig, Andreas; Matthäus, Christian; Romeike, Bernd F M; Brehm, Bernhard R; Limpert, Jens; Tünnermann, Andreas; Guntinas-Lichius, Orlando; Dietzek, Benjamin; Schmitt, Michael; Popp, Jürgen


    The past years have seen increasing interest in nonlinear optical microscopic imaging approaches for the investigation of diseases due to the method's unique capabilities of deep tissue penetration, 3D sectioning and molecular contrast. Its application in clinical routine diagnostics, however, is hampered by large and costly equipment requiring trained staff and regular maintenance, hence it has not yet matured to a reliable tool for application in clinics. In this contribution implementing a novel compact fiber laser system into a tailored designed laser scanning microscope results in a small footprint easy to use multimodal imaging platform enabling simultaneously highly efficient generation and acquisition of second harmonic generation (SHG), two-photon excited fluorescence (TPEF) as well as coherent anti-Stokes Raman scattering (CARS) signals with optimized CARS contrast for lipid imaging for label-free investigation of tissue samples. The instrument combining a laser source and a microscope features a unique combination of the highest NIR transmission and a fourfold enlarged field of view suited for investigating large tissue specimens. Despite its small size and turnkey operation rendering daily alignment dispensable the system provides the highest flexibility, an imaging speed of 1 megapixel per second and diffraction limited spatial resolution. This is illustrated by imaging samples of squamous cell carcinoma of the head and neck (HNSCC) and an animal model of atherosclerosis allowing for a complete characterization of the tissue composition and morphology, i.e. the tissue's morphochemistry. Highly valuable information for clinical diagnostics, e.g. monitoring the disease progression at the cellular level with molecular specificity, can be retrieved. Future combination with microscopic probes for in vivo imaging or even implementation in endoscopes will allow for in vivo grading of HNSCC and characterization of plaque deposits towards the detection of high

  17. Clinical development of BLZ-100 for real-time optical imaging of tumors during resection (United States)

    Franklin, Heather L.; Miller, Dennis M.; Hedges, Teresa; Perry, Jeff; Parrish-Novak, Julia


    Complete initial resection can give cancer patients the best opportunity for long-term survival. There is unmet need in surgical oncology for optical imaging that enables simple and precise visualization of tumors and consistent contrast with surrounding normal tissues. Near-infrared (NIR) contrast agents and camera systems that can detect them represent an area of active research and development. The investigational Tumor Paint agent BLZ-100 is a conjugate of a chlorotoxin peptide and the NIR dye indocyanine green (ICG) that has been shown to specifically bind to a broad range of solid tumors. Clinical efficacy studies with BLZ-100 are in progress, a necessary step in bringing the product into clinical practice. To ensure a product that will be useful for and accepted by surgeons, the early clinical development of BLZ- 100 incorporates multiple tumor types and imaging devices so that surgeon feedback covers the range of anticipated clinical uses. Key contrast agent characteristics include safety, specificity, flexibility in timing between dose and surgery, and breadth of tumor types recognized. Imaging devices should use wavelengths that are optimal for the contrast agent, be sensitive enough that contrast agent dosing can be adjusted for optimal contrast, include real-time video display of fluorescence and white light image, and be simple for surgeons to use with minimal disruption of surgical flow. Rapid entry into clinical studies provides the best opportunity for early surgeon feedback, enabling development of agents and devices that will gain broad acceptance and provide information that helps surgeons achieve more complete and precise resections.

  18. Introduction to Pre-clinical Imaging Techniques; Introduccion a las tecnicas de imagen preclinica

    Energy Technology Data Exchange (ETDEWEB)

    Mulero, F.


    Biomedical research poses increasingly complex problems regarding the biochemical processes that take place in living organisms. Just as in clinical research, medical imaging techniques are an excellent tool to study these processes. One of the most outstanding techniques is what is called molecular imaging, the best tool for which is positron emission tomography (PET). PET is capable of monitoring those processes in vivo at a molecular level and it can be used in multiple applications, including the development of new drugs, the study of human disease models in animals, and the characterization of gene expression and phenotype changes caused by genetic manipulation (transgenic and knockout animals). (Author) 5 refs.

  19. Cross-sectional imaging of biliary tumors: current clinical status and future developments

    Energy Technology Data Exchange (ETDEWEB)

    Zech, Christoph J.; Schoenberg, Stefan O.; Reiser, Maximilian; Helmberger, Thomas [Institute of Clinical Radiology, Munich University Hospitals-Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich (Germany)


    Extrahepatic cholangiocarcinoma, including hilar cholangiocarcinoma, is a relatively rare diagnosis. However, it frequently has been associated with major problems in diagnostics and clinical management from its first comprehensive description by Klatskin up until today. In this article, cholangiocarcinoma, representing the most common biliary tumor, as well as the differential diagnoses of benign and malignant biliary obstruction, will be discussed. The latest improvements of cross-sectional imaging modalities (sonography, CT, MRI and PET) and their diagnostic values for detection and staging will be displayed. A practical imaging-based diagnostic approach to obstructive biliary disease will be proposed. (orig.)

  20. A social-technological epistemology of clinical decision-making as mediated by imaging. (United States)

    van Baalen, Sophie; Carusi, Annamaria; Sabroe, Ian; Kiely, David G


    In recent years there has been growing attention to the epistemology of clinical decision-making, but most studies have taken the individual physicians as the central object of analysis. In this paper we argue that knowing in current medical practice has an inherently social character and that imaging plays a mediating role in these practices. We have analyzed clinical decision-making within a medical expert team involved in diagnosis and treatment of patients with pulmonary hypertension (PH), a rare disease requiring multidisciplinary team involvement in diagnosis and management. Within our field study, we conducted observations, interviews, video tasks, and a panel discussion. Decision-making in the PH clinic involves combining evidence from heterogeneous sources into a cohesive framing of a patient, in which interpretations of the different sources can be made consistent with each other. Because pieces of evidence are generated by people with different expertise and interpretation and adjustments take place in interaction between different experts, we argue that this process is socially distributed. Multidisciplinary team meetings are an important place where information is shared, discussed, interpreted, and adjusted, allowing for a collective way of seeing and a shared language to be developed. We demonstrate this with an example of image processing in the PH service, an instance in which knowledge is distributed over multiple people who play a crucial role in generating an evaluation of right heart function. Finally, we argue that images fulfill a mediating role in distributed knowing in 3 ways: first, as enablers or tools in acquiring information; second, as communication facilitators; and third, as pervasively framing the epistemic domain. With this study of clinical decision-making in diagnosis and treatment of PH, we have shown that clinical decision-making is highly social and mediated by technologies. The epistemology of clinical decision-making needs

  1. Clinical value of somatostatin receptor imaging in patients with suspected head and neck paragangliomas

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, Matthias; Dietlein, Markus; Weber, Kerstin; Moka, Detlef; Schicha, Harald [Klinik und Poliklinik fuer Nuklearmedizin, Universitaet zu Koeln, Joseph-Stelzmann-Strasse 9, 50924 Koeln (Germany); Fischer, Eva; Michel, Olaf; Stennert, Eberhard [Klinik und Poliklinik fuer Hals-, Nasen- und Ohrenheilkunde, Universitaet zu Koeln, Koeln (Germany)


    Paragangliomas or glomus tumours of the head and neck region are rare somatostatin receptor-expressing neuroendocrine tumours. Precise preoperative diagnosis is of special importance in order to adequately weigh the potential benefit of the operation against the inherent risks of the procedure. In this study, the clinical value of somatostatin receptor imaging was assessed in 19 patients who underwent somatostatin receptor scintigraphy because of known or suspected paraganglioma of the head and neck region. The results were compared with the results of computed tomography and/or magnetic resonance imaging, histology and clinical follow-up. [{sup 111}In-DTPA-D-Phe{sup 1}]-octreotide scintigraphy was performed 4-6 and 24 h after i.v. injection of 140-220 MBq {sup 111}In-octreotide. Whole-body and planar images as well as single-photon emission tomography images were acquired and lesions were graded according to qualitative tracer uptake. Somatostatin receptor imaging was positive in nine patients, identifying paragangliomas for the first time in three patients and recurrent disease in six patients. In one patient, a second, previously unknown paraganglioma site was identified. Negative results were obtained in ten patients. These patients included one suffering from chronic hyperplastic otitis externa, one with granuloma tissue and an organised haematoma, one with an acoustic neuroma, one with an asymmetric internal carotid artery, two with ectasia of the bulbus venae jugularis and one with a jugular vein thrombosis. In two patients with a strong family history of paraganglioma, individual involvement could be excluded. In only one patient did somatostatin receptor imaging and magnetic resonance imaging yield false negative results in respect of recurrent paraganglioma tissue. It is concluded that somatostatin receptor scintigraphy provides important information in patients with suspected paragangliomas of the head and neck region and has a strong impact on further

  2. Fully automated corneal endothelial morphometry of images captured by clinical specular microscopy (United States)

    Bucht, Curry; Söderberg, Per; Manneberg, Göran


    The corneal endothelium serves as the posterior barrier of the cornea. Factors such as clarity and refractive properties of the cornea are in direct relationship to the quality of the endothelium. The endothelial cell density is considered the most important morphological factor of the corneal endothelium. Pathological conditions and physical trauma may threaten the endothelial cell density to such an extent that the optical property of the cornea and thus clear eyesight is threatened. Diagnosis of the corneal endothelium through morphometry is an important part of several clinical applications. Morphometry of the corneal endothelium is presently carried out by semi automated analysis of pictures captured by a Clinical Specular Microscope (CSM). Because of the occasional need of operator involvement, this process can be tedious, having a negative impact on sampling size. This study was dedicated to the development and use of fully automated analysis of a very large range of images of the corneal endothelium, captured by CSM, using Fourier analysis. Software was developed in the mathematical programming language Matlab. Pictures of the corneal endothelium, captured by CSM, were read into the analysis software. The software automatically performed digital enhancement of the images, normalizing lights and contrasts. The digitally enhanced images of the corneal endothelium were Fourier transformed, using the fast Fourier transform (FFT) and stored as new images. Tools were developed and applied for identification and analysis of relevant characteristics of the Fourier transformed images. The data obtained from each Fourier transformed image was used to calculate the mean cell density of its corresponding corneal endothelium. The calculation was based on well known diffraction theory. Results in form of estimated cell density of the corneal endothelium were obtained, using fully automated analysis software on 292 images captured by CSM. The cell density obtained by the

  3. SU-E-J-181: Magnetic Resonance Image-Guided Radiation Therapy Workflow: Initial Clinical Experience

    Energy Technology Data Exchange (ETDEWEB)

    Green, O; Kashani, R; Santanam, L; Wooten, H; Li, H; Rodriguez, V; Hu, Y; Mutic, S [Washington University School of Medicine, St. Louis, MO (United States); Hand, T; Victoria, J [ViewRay, Inc., Oakwood Village, OH (United States); Steele, C [Barnes Jewish Hospital, St Louis, MO (United States)


    Purpose: The aims of this work are to describe the workflow and initial clinical experience treating patients with an MRI-guided radiotherapy (MRIGRT) system. Methods: Patient treatments with a novel MR-IGRT system started at our institution in mid-January. The system consists of an on-board 0.35-T MRI, with IMRT-capable delivery via doubly-focused MLCs on three {sup 60} Co heads. In addition to volumetric MR-imaging, real-time planar imaging is performed during treatment. So far, eleven patients started treatment (six finished), ranging from bladder to lung SBRT. While the system is capable of online adaptive radiotherapy and gating, a conventional workflow was used to start, consisting of volumetric imaging for patient setup using visible tumor, evaluation of tumor motion outside of PTV on cine images, and real-time imaging. Workflow times were collected and evaluated to increase efficiency and evaluate feasibility of adding the adaptive and gating features while maintaining a reasonable patient throughput. Results: For the first month, physicians attended every fraction to provide guidance on identifying the tumor and an acceptable level of positioning and anatomical deviation. Average total treatment times (including setup) were reduced from 55 to 45 min after physician presence was no longer required and the therapists had learned to align patients based on soft-tissue imaging. Presently, the source strengths were at half maximum (7.7K Ci each), therefore beam-on times will be reduced after source replacement. Current patient load is 10 per day, with increase to 25 anticipated in the near future. Conclusion: On-board, real-time MRI-guided RT has been incorporated into clinical use. Treatment times were kept to reasonable lengths while including volumetric imaging, previews of tumor movement, and physician evaluation. Workflow and timing is being continuously evaluated to increase efficiency. In near future, adaptive and gating capabilities of the system will

  4. Nuclear medicine in the acute clinical setting: indications, imaging findings, and potential pitfalls. (United States)

    Uliel, Livnat; Mellnick, Vincent M; Menias, Christine O; Holz, Andrew L; McConathy, Jonathan


    Nuclear medicine imaging provides valuable functional information that complements information obtained with anatomic imaging techniques in the evaluation of patients with specific acute clinical manifestations. Nuclear medicine studies are most often used in conjunction with other imaging modalities and as a problem-solving tool. Under certain circumstances a nuclear medicine study may be indicated as the first-line imaging modality, as in the case of renal scintigraphy for transplant dysfunction in the early postoperative period. Nuclear imaging may be preferred when a conventional first-line study is contraindicated or when it is important to minimize radiation exposure. The portability of nuclear imaging offers particular advantages for the evaluation of critically ill patients whose clinical condition is unstable and who cannot be safely transported out of the intensive care unit. The ability to visualize physiologic and pathophysiologic processes over relatively long time periods without adding to the patient's radiation exposure contributes to the high diagnostic sensitivity of several types of nuclear medicine studies. Viewing the acquired images in the cine mode adds to the value of these studies for diagnosing and characterizing dynamic abnormalities such as intermittent internal bleeding and bile or urine leakage. In this pictorial review, the spectrum of nuclear medicine studies commonly performed in the acute care setting is reviewed according to body systems and organs, with detailed descriptions of the indications, technical considerations, findings, and potential pitfalls of each type of study. Supplemental material available at

  5. The first clinical treatment with kilovoltage intrafraction monitoring (KIM): A real-time image guidance method

    Energy Technology Data Exchange (ETDEWEB)

    Keall, Paul J., E-mail:; O’Brien, Ricky; Huang, Chen-Yu [Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Camperdown, New South Wales 2006 (Australia); Aun Ng, Jin [Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Camperdown, New South Wales 2006, Australia and School of Physics, University of Sydney, Camperdown, New South Wales 2006 (Australia); Colvill, Emma [Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Camperdown, New South Wales 2006, Australia and Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales 2065 (Australia); Rugaard Poulsen, Per; Fledelius, Walther [Department of Oncology, Aarhus University Hospital, 8000 Aarhus C, Denmark and Institute of Clinical Medicine, Aarhus University, 8000 Aarhus C (Denmark); Juneja, Prabhjot; Booth, Jeremy T. [School of Physics, University of Sydney, Camperdown, New South Wales 2006, Australia and Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales 2065 (Australia); Simpson, Emma; Bell, Linda; Alfieri, Florencia; Eade, Thomas; Kneebone, Andrew [Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales 2065 (Australia)


    Purpose: Kilovoltage intrafraction monitoring (KIM) is a real-time image guidance method that uses widely available radiotherapy technology, i.e., a gantry-mounted x-ray imager. The authors report on the geometric and dosimetric results of the first patient treatment using KIM which occurred on September 16, 2014. Methods: KIM uses current and prior 2D x-ray images to estimate the 3D target position during cancer radiotherapy treatment delivery. KIM software was written to process kilovoltage (kV) images streamed from a standard C-arm linear accelerator with a gantry-mounted kV x-ray imaging system. A 120° pretreatment kV imaging arc was acquired to build the patient-specific 2D to 3D motion correlation. The kV imager was activated during the megavoltage (MV) treatment, a dual arc VMAT prostate treatment, to estimate the 3D prostate position in real-time. All necessary ethics, legal, and regulatory requirements were met for this clinical study. The quality assurance processes were completed and peer reviewed. Results: During treatment, a prostate position offset of nearly 3 mm in the posterior direction was observed with KIM. This position offset did not trigger a gating event. After the treatment, the prostate motion was independently measured using kV/MV triangulation, resulting in a mean difference of less than 0.6 mm and standard deviation of less than 0.6 mm in each direction. The accuracy of the marker segmentation was visually assessed during and after treatment and found to be performing well. During treatment, there were no interruptions due to performance of the KIM software. Conclusions: For the first time, KIM has been used for real-time image guidance during cancer radiotherapy. The measured accuracy and precision were both submillimeter for the first treatment fraction. This clinical translational research milestone paves the way for the broad implementation of real-time image guidance to facilitate the detection and correction of geometric and

  6. Imaging of athletic pubalgia and core muscle injuries: clinical and therapeutic correlations. (United States)

    Palisch, Andrew; Zoga, Adam C; Meyers, William C


    Athletes frequently injure their hips and core muscles. Accurate diagnosis and proper treatment of groin pain in the athlete can be tricky, frequently posing vexing problem for trainers and physicians. Clinical presentations of the various hip problems overlap with respect to history and physical examination. This article reviews clinical presentations and magnetic resonance imaging findings specific to the various causes of groin pain in the athlete. The focus is on the core muscle injuries (athletic pubalgia or "sports hernia"). The goal is to raise awareness about the variety of injuries that occur and therapeutic options.

  7. Clinical indications for digital imaging in dento-alveolar trauma. Part 2: root resorption. (United States)

    Cohenca, Nestor; Simon, James H; Mathur, Aeshna; Malfaz, Jose Maria


    Common complications of dento-alveolar trauma are pulp necrosis, pulp canal obliteration, periapical pathosis and root resorption. Different types of root resorption have been identified with traumatic injuries. Repair-related (surface), infection-related (inflammatory), ankylosis-related (osseous replacement) or extraradicular invasive cervical resorption are among the most common. Recent developments in imaging systems have enabled clinicians to visualize structural changes effectively. The diagnosis and three-dimensional imaging assessment of the resorption is important in order to determine the treatment complexity and expected outcome based on the location and extension of the root defect. This article discusses and illustrates the clinical application of cone beam computed tomography for diagnosis and treatment plan of root resorption. Four clinical cases are presented to illustrate the potential use of the NewTom 3G for root resorption.

  8. Magnetic resonance imaging in the differential diagnosis of true placenta accreta: a clinical case

    Directory of Open Access Journals (Sweden)

    E. V. Tarachkova


    Full Text Available True placenta accreta is the attachment of chorionic villi to the myometrium, possibly penetrating into the thickness of the myometrium and its outside, including through the serous tunic. The main current diagnostic techniques are considered to be ultrasonography, laboratory diagnosis (elevated human chorionic gonadotropin and placental lactogen levels, and clinical data (pain and vaginal discharge. Magnetic resonance imaging is deemed to be an adjuvant technique. By using a clinical example, this paper considers the capabilities of magnetic resonance imaging to diagnose this abnormality and to choose a right treatment policy. The abnormality is compared with the conditions (trophoblastic tumor and myoma with lysis that are similar in their diagnosis and magnetic resonance pattern. The disorder in question is rather rare and its detailed consideration, determination of the capabilities of various techniques, and comparison with externally similar cases areimportant for the development of diagnostic opportunities.

  9. Cardiac CT for the assessment of chest pain: Imaging techniques and clinical results

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Hans-Christoph, E-mail: [Ludwig-Maximilians-University, Grosshadern Clinic, Department of Clinical Radiology, Marchioninistr. 15, 81377 Munich (Germany); Johnson, Thorsten [Ludwig-Maximilians-University, Grosshadern Clinic, Department of Clinical Radiology, Marchioninistr. 15, 81377 Munich (Germany)


    Immediate and efficient risk stratification and management of patients with acute chest pain in the emergency department is challenging. Traditional management of these patients includes serial ECG, laboratory tests and further on radionuclide perfusion imaging or ECG treadmill testing. Due to the advances of multi-detector CT technology, dedicated coronary CT angiography provides the potential to rapidly and reliably diagnose or exclude acute coronary artery disease. Life-threatening causes of chest pain, such as aortic dissection and pulmonary embolism can simultaneously be assessed with a single scan, sometimes referred to as “triple rule out” scan. With appropriate patient selection, cardiac CT can accurately diagnose heart disease or other sources of chest pain, markedly decrease health care costs, and reliably predict clinical outcomes. This article reviews imaging techniques and clinical results for CT been used to evaluate patients with chest pain entering the emergency department.

  10. Clinical, Biological, and Imaging Features of Monogenic Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Andrea Pilotto


    Full Text Available The discovery of monogenic forms of Alzheimer’s Disease (AD associated with mutations within PSEN1, PSEN2, and APP genes is giving a big contribution in the understanding of the underpinning mechanisms of this complex disorder. Compared with sporadic form, the phenotype associated with monogenic cases is somewhat broader including behavioural disturbances, epilepsy, myoclonus, and focal presentations. Structural and functional imaging show typical early changes also in presymptomatic monogenic carriers. Amyloid imaging and CSF tau/Aβ ratio may be useful in the differential diagnosis with other neurodegenerative dementias, especially, in early onset cases. However, to date any specific biomarkers of different monogenic cases have been identified. Thus, in clinical practice, the early identification is often difficult, but the copresence of different elements could help in recognition. This review will focus on the clinical and instrumental markers useful for the very early identification of AD monogenic cases, pivotal in the development, and evaluation of disease-modifying therapy.

  11. In vivo three-dimensional photoacoustic imaging based on a clinical matrix array ultrasound probe (United States)

    Wang, Yu; Erpelding, Todd N.; Jankovic, Ladislav; Guo, Zijian; Robert, Jean-Luc; David, Guillaume; Wang, Lihong V.


    We present an integrated photoacoustic and ultrasonic three-dimensional (3-D) volumetric imaging system based on a two-dimensional (2-D) matrix array ultrasound probe. A wavelength-tunable dye laser pumped by a Q-switched Nd:YAG laser serves as the light source and a modified commercial ultrasound imaging system (iU22, Philips Healthcare) with a 2-D array transducer (X7-2, Philips Healthcare) detects both the pulse-echo ultrasound and photoacoustic signals. A multichannel data acquisition system acquires the RF channel data. The imaging system enables rendering of co-registered 3-D ultrasound and photoacoustic images without mechanical scanning. The resolution along the azimuth, elevation, and axial direction are measured to be 0.69, 0.90 and 0.84 mm for photoacoustic imaging. In vivo 3-D photoacoustic mapping of the sentinel lymph node was demonstrated in a rat model using methylene blue dye. These results highlight the clinical potential of 3-D PA imaging for identification of sentinel lymph nodes for cancer staging in humans.

  12. Imaging breast lesions using the Twente photoacoustic mammoscope: ongoing clinical experience (United States)

    Heijblom, M.; Piras, D.; Xia, W.; van Hespen, J. C. G.; van den Engh, F. M.; Klaase, J. M.; van Leeuwen, T. G.; Steenbergen, W.; Manohar, S.


    Current imaging modalities are often not able to detect early stages of breast cancer with high imaging contrast. Visualizing malignancy-associated increased hemoglobin concentrations might improve breast cancer diagnosis. Photoacoustic imaging can visualize hemoglobin in tissue with optical contrast and ultrasound resolution, which makes it potentially ideal for breast imaging. The Twente Photoacoustic Mammoscope (PAM) has been designed specifically for this purpose. Based on a successful pilot study in 2007, a large clinical study using PAM has been started in December 2010. PAM uses a pulsed Q-switched Nd:YAG laser at 1064 nm to illuminate a region of interest on the breast. Photoacoustic signals are detected with a 1MHz, unfocused ultrasound detector array. Three dimensional data are reconstructed using an acoustic backprojection algorithm. Those reconstructed images are compared with conventional imaging and histopathology. In the first phase of the study, the goal was to optimize the visualization of malignancies. We performed sixteen technically acceptable measurements on confined breast malignancies. In the reconstructed volumes of all malignancies, a confined high contrast region could be identified at the expected lesion depth. After ten successful measurements, the illumination area was increased and the fluence was substantially decreased. This caused a further significant increase in PAM lesion contrast.

  13. Breast imaging using the Twente photoacoustic mammoscope (PAM): new clinical measurements (United States)

    Heijblom, Michelle; Piras, Daniele; Ten Tije, Ellen; Xia, Wenfeng; van Hespen, Johan; Klaase, Joost; van den Engh, Frank; van Leeuwen, Ton; Steenbergen, Wiendelt; Manohar, Srirang


    Worldwide, yearly about 450,000 women die from the consequences of breast cancer. Current imaging modalities are not optimal in discriminating benign from malignant tissue. Visualizing the malignancy-associated increased hemoglobin concentration might significantly improve early diagnosis of breast cancer. Since photoacoustic imaging can visualize hemoglobin in tissue with optical contrast and ultrasound-like resolution, it is potentially an ideal method for early breast cancer imaging. The Twente Photoacoustic Mammoscope (PAM) has been developed specifically for breast imaging. Recently, a large clinical study has been started in the Medisch Spectrum Twente in Oldenzaal using PAM. In PAM, the breast is slightly compressed between a window for laser light illumination and a flat array ultrasound detector. The measurements are performed using a Q-switched Nd:YAG laser, pulsed at 1064 nm and a 1 MHz unfocused ultrasound detector array. Three-dimensional data are reconstructed using a delay and sum reconstruction algorithm. Those reconstructed images are compared with conventional imaging and histopathology. In the first phase of the study 12 patients with a malignant lesion and 2 patients with a benign cyst have been measured. The results are used to guide developments in photoacoustic mammography in order to pave the way towards an optimal technique for early diagnosis of breast cancer.

  14. Clinical significance of pontine high signals identified on magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Masaki; Takahashi, Akira (Nagoya Univ. (Japan). Faculty of Medicine); Arahata, Yutaka; Motegi, Yoshimasa; Furuse, Masahiro


    Spin-echo magnetic resonance imaging (MRI) was evaluated to 530 cases in order to investigate the clinical significance of pontine high signals. The subjects comprised 109 cases of pontine infarction with high signal on T[sub 2]-weighted image and low signal on T[sub 1]-weighted image (PI group), 145 of pontine high signal with high signal on T[sub 2]-weighted image but normal signal on T[sub 1]-weighted image (PH group) and 276 of age-matched control without abnormality either on T[sub 1] or T[sub 2]-weighted images (AC group). Subjective complaints such as vertigo-dizziness were more frequent in the PH group than in the PI group. In both PI and groups, periventricular hyperintensity as well as subcortical high signals in the supratentorium were more severe than in the AC group. These degrees were higher in the PI group than in the PH group. In conclusion, PH as well as PI may result from diffuse arteriosclerosis and PH is considered to be an early finding of pontine ischemia. (author).

  15. Clinical safety of magnetic resonance imaging in patients with implanted SynchroMed EL infusion pumps

    Energy Technology Data Exchange (ETDEWEB)

    Diehn, Felix E.; Wood, Christopher P.; Watson, Robert E.; Hunt, Christopher H. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Mauck, William D. [Mayo Clinic, Department of Anesthesiology, Rochester, MN (United States); Burke, Michelle M. [Mayo Clinic, Department of Psychiatry and Psychology, Rochester, MN (United States)


    Patients with implanted SynchroMed spinal infusion pumps (Medtronic, Inc., Minneapolis, MN) routinely undergo magnetic resonance imaging at our institution. In August 2008, Medtronic issued an urgent medical device correction report regarding several pumps. Because of the rare potential ''for a delay in the return of proper drug infusion'' and ''for a delay in the logging of motor stall events,'' ''a patient's pump must be interrogated after MRI exposure in order to confirm proper pump functionality.'' This is particularly important in patients receiving intrathecal baclofen, for whom a delay in return of proper pump infusion could lead to life-threatening baclofen withdrawal syndrome. The objective of this report is to present our experience and protocol of performing magnetic resonance imaging in patients with implanted SynchroMed EL pumps. We retrospectively reviewed records of 86 patients with implanted SynchroMed EL spinal infusion pumps who underwent 112 examinations on 1.5-T magnetic resonance imaging scanners from September 1, 1998 to July 7, 2004. No SynchroMed EL pumps were damaged by magnetic resonance imaging, and the programmable settings remained unchanged in all patients. Our data suggest that SynchroMed EL pump malfunction is indeed rare after routine clinical 1.5-T magnetic resonance imaging examinations. However, based on the Medtronic correction report, we perform pump interrogation before and after imaging. (orig.)

  16. In vivo inflammation mapping of periodontal disease based on diffuse reflectance spectral imaging: a clinical study (United States)

    Prasanth, Chandra Sekhar; Betsy, Joseph; Jayanthi, Jayaraj L.; Nisha, Unni G.; Prasantila, Janam; Subhash, Narayanan


    Since conventional techniques using periodontal probes have inherent drawbacks in the diagnosis of different grades of gingival inflammation, development of noninvasive screening devices becomes significant. Diffuse reflectance (DR) spectra recorded with white light illumination is utilized to detect periodontal inflammation from the oxygenated hemoglobin absorption ratio R620/R575. A multispectral imaging system is utilized to record narrow-band DR images at 575 and 620 nm from the anterior sextant of the gingivia of 15 healthy volunteers and 25 patients (N=40). An experienced periodontist assesses the level of gingival inflammation at each site through periodontal probing and assigns diagnosis as healthy, mild, moderate, or severe inflammation. The DR image ratio R620/R575 computed for each pixel (8-μm resolution) from the monochrome images is pseudo-color-mapped to identify gingival inflammation sites. The DR image ratio values at each site are compared with clinical diagnosis to estimate the specificity and sensitivity of the DR imaging technique in inflammation mapping. The high diagnostic accuracy is utilized to detect underlying inflammation in six patients with a previous history of periodontitis.

  17. Clinical value of CT three-dimensional imaging in diagnosing gastrointestinal tract diseases

    Institute of Scientific and Technical Information of China (English)

    Shao-Yin Duan; Dan-Tong Zhang; Qing-Chi Lin; Yan-Huan Wu


    AIM: To discuss the clinical value of CT three-dimensional (3-D) imaging in diagnosing gastrointestinal tract diseases.METHODS: Three-D imaging findings of 52 patients were retrospectively analyzed. Three-D imaging methods included shaded surface display (SSD), volume rendering (VR), virtual endoscopy (VE) and multiplanar reformatting (MPR). The diagnosis results of CT 3-D were evaluated by comparison with those of endoscopy and/or surgical finding.RESULTS: Fifty-two patients with gastrointestinal tract diseases were diagnosed by CT 3-D imaging, of whom 50 cases were correctly diagnosed and 2 were misdiagnosed. There were 33 cases of gastric diseases (27 with carcinoma, 5 with peptic ulcer and 1 with leiomyoma) and 19 large intestinal diseases (10 with colon carcinoma, 2 with carcinoma of the rectum, 5 with colon polypus and 2 with tuberculosis of the ileocecal junction). Twenty-two cases with prominent lesions (9 with subsequent hollow lesions), 20 with stenosis of cavity (8 with concomitant prominent lesions) and 10 with hollow lesions (5 with concomitant prominent lesions) were shown in 3-D images. The minimal lesion shown was 1.0 cm × 0.8 cm × 0.5 cm.CONCLUSION: CT 3-D imaging, a non-invasive examination without pain, can display clearly and directly the lesions of gastrointestinal tract with accurate location and high diagnosis accuracy. It is an important complementary technique to endoscopy.

  18. [Image guided and robotic treatment--the advance of cybernetics in clinical medicine]. (United States)

    Fosse, E; Elle, O J; Samset, E; Johansen, M; Røtnes, J S; Tønnessen, T I; Edwin, B


    The introduction of advanced technology in hospitals has changed the treatment practice towards more image guided and minimal invasive procedures. Modern computer and communication technology opens up for robot aided and pre-programmed intervention. Several robotic systems are in clinical use today both in microsurgery and in major cardiac and orthopedic operations. As this trend develops, professions which are new in this context such as physicists, mathematicians and cybernetic engineers will be increasingly important in the treatment of patients.

  19. Structural and diffusion imaging versus clinical assessment to monitor amyotrophic lateral sclerosis (United States)

    Cardenas-Blanco, Arturo; Machts, Judith; Acosta-Cabronero, Julio; Kaufmann, Joern; Abdulla, Susanne; Kollewe, Katja; Petri, Susanne; Schreiber, Stefanie; Heinze, Hans-Jochen; Dengler, Reinhard; Vielhaber, Stefan; Nestor, Peter J.


    Amyotrophic lateral sclerosis is a progressive neurodegenerative disease that affects upper and lower motor neurons. Observational and intervention studies can be tracked using clinical measures such as the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) but for a complete understanding of disease progression, objective in vivo biomarkers of both central and peripheral motor pathway pathology are highly desirable. The aim of this study was to determine the utility of structural and diffusion imaging as central nervous system biomarkers compared to the standard clinical measure, ALSFRS-R, to track longitudinal evolution using three time-point measurements. N = 34 patients with ALS were scanned and clinically assessed three times at a mean of three month time intervals. The MRI biomarkers were structural T1-weighted volumes for cortical thickness measurement as well as deep grey matter volumetry, voxel-based morphometry and diffusion tensor imaging (DTI). Cortical thickness focused specifically on the precentral gyrus while quantitative DTI biomarkers focused on the corticospinal tracts. The evolution of imaging biomarkers and ALSFRS-R scores over time were analysed using a mixed effects model that accounted for the scanning interval as a fixed effect variable, and, the initial measurements and time from onset as random variables. The mixed effects model showed a significant decrease in the ALSFRS-R score, (p  0.5). In addition, deep grey matter volumetry and voxel-based morphometry also identified no significant changes. Furthermore, the availability of three time points was able to indicate that there was a linear progression in both clinical and fractional anisotropy measures adding to the validity of these results. The results indicate that DTI is clearly a superior imaging marker compared to atrophy for tracking the evolution of the disease and can act as a central nervous biomarker in longitudinal studies. It remains, however, less

  20. Clinical and image improvement of Raynaud's phenomenon after botulinum toxin type A treatment. (United States)

    Zhao, HongMei; Lian, YaJun


    Raynaud's phenomenon is often accompanied by pain, digital ulceration and compromised daily activities. Pharmacological therapy or sympathectomies have been administered to diminish these symptoms but existing treatments are not invariably efficacious. A recent case series has described the use of botulinum toxin type A in the treatment of Raynaud's phenomenon. We report two patients with severe or mild Raynaud's phenomenon who were injected with BTX-A; both of whom experienced clinical and image improvement after treatment.

  1. Structural and diffusion imaging versus clinical assessment to monitor amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    Arturo Cardenas-Blanco


    Full Text Available Amyotrophic lateral sclerosis is a progressive neurodegenerative disease that affects upper and lower motor neurons. Observational and intervention studies can be tracked using clinical measures such as the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R but for a complete understanding of disease progression, objective in vivo biomarkers of both central and peripheral motor pathway pathology are highly desirable. The aim of this study was to determine the utility of structural and diffusion imaging as central nervous system biomarkers compared to the standard clinical measure, ALSFRS-R, to track longitudinal evolution using three time-point measurements. N = 34 patients with ALS were scanned and clinically assessed three times at a mean of three month time intervals. The MRI biomarkers were structural T1-weighted volumes for cortical thickness measurement as well as deep grey matter volumetry, voxel-based morphometry and diffusion tensor imaging (DTI. Cortical thickness focused specifically on the precentral gyrus while quantitative DTI biomarkers focused on the corticospinal tracts. The evolution of imaging biomarkers and ALSFRS-R scores over time were analysed using a mixed effects model that accounted for the scanning interval as a fixed effect variable, and, the initial measurements and time from onset as random variables. The mixed effects model showed a significant decrease in the ALSFRS-R score, (p  0.5. In addition, deep grey matter volumetry and voxel-based morphometry also identified no significant changes. Furthermore, the availability of three time points was able to indicate that there was a linear progression in both clinical and fractional anisotropy measures adding to the validity of these results. The results indicate that DTI is clearly a superior imaging marker compared to atrophy for tracking the evolution of the disease and can act as a central nervous biomarker in longitudinal studies. It

  2. Molecular image-directed biopsies: improving clinical biopsy selection in patients with multiple tumors (United States)

    Harmon, Stephanie A.; Tuite, Michael J.; Jeraj, Robert


    Site selection for image-guided biopsies in patients with multiple lesions is typically based on clinical feasibility and physician preference. This study outlines the development of a selection algorithm that, in addition to clinical requirements, incorporates quantitative imaging data for automatic identification of candidate lesions for biopsy. The algorithm is designed to rank potential targets by maximizing a lesion-specific score, incorporating various criteria separated into two categories: (1) physician-feasibility category including physician-preferred lesion location and absolute volume scores, and (2) imaging-based category including various modality and application-specific metrics. This platform was benchmarked in two clinical scenarios, a pre-treatment setting and response-based setting using imaging from metastatic prostate cancer patients with high disease burden (multiple lesions) undergoing conventional treatment and receiving whole-body [18F]NaF PET/CT scans pre- and mid-treatment. Targeting of metastatic lesions was robust to different weighting ratios and candidacy for biopsy was physician confirmed. Lesion ranked as top targets for biopsy remained so for all patients in pre-treatment and post-treatment biopsy selection after sensitivity testing was completed for physician-biased or imaging-biased scenarios. After identifying candidates, biopsy feasibility was evaluated by a physician and confirmed for 90% (32/36) of high-ranking lesions, of which all top choices were confirmed. The remaining cases represented lesions with high anatomical difficulty for targeting, such as proximity to sciatic nerve. This newly developed selection method was successfully used to quantitatively identify candidate lesions for biopsies in patients with multiple lesions. In a prospective study, we were able to successfully plan, develop, and implement this technique for the selection of a pre-treatment biopsy location.

  3. Clinical diagnosis of neuromuscular diseases using fat/water suppression magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Tsubahara, Akio [Kawasaki Medical School, Kurashiki, Okayama (Japan); Okajima, Yasutomo


    Pixel values in fat/water suppression MRI, and the T1 and T2 relaxation times of skeletal muscles were measured to establish criteria for the clinical MRI diagnosis of neuromuscular diseases. The subjects were 15 patients with a diagnosis of neuromuscular disease based on clinical symptoms and findings made by electrophysiological methods, and 3 patients with hysterical conversion reactions. Normal values were obtained from 33 healthy volunteers. Transaxial MR images of the bilateral thigh muscles were recorded with T1/T2 relaxation time calculation imaging and fat/water suppression imaging (Dixon`s method). The patients with muscular dystrophy showed remarkably decreased pixel values in their water images (PV 1) and tremendously increased pixel values in their fat images (PV 2). The finding that T1 became much shorter and T2 slightly longer seemed to be related to the fact that the extent of the increase in PV 2 was relatively greater than that of the decrease in PV 1. The patients with polymyositis showed a PV 1 value that was higher than normal. This finding was quite different from that for muscular dystrophy. As this disease grew worse, the PV 2 increased. The length of T1 seemed to depend on the relationship between PV 1 and PV 2. Prolongation of T2 appeared to be due to increase in PV 2. Both PV 1 and PV 2 in myotonic dystrophy and neurogenic diseases were slightly higher than normal. The patients with polyradiculoneuropathy showed both T1 and T2 relaxation times that were longer than normal. However, the T1 relaxation time in motor neuron diseases had a tendency to become shorter. The parameters in the patients with hysterical conversion reactions remained approximately within normal range. We concluded that measurements of the objective parameters in MRI are useful for the clinical diagnosis of neuromuscular diseases. (author)

  4. Spontaneous rupture of the distal iliopsoas tendon: clinical and imaging findings, with anatomic correlations. (United States)

    Lecouvet, Frederic E; Demondion, Xavier; Leemrijse, Thibaut; Vande Berg, Bruno C; Devogelaer, Jean-Pierre; Malghem, Jacques


    We report the clinical and imaging findings in two elderly female patients with spontaneous rupture of the distal iliopsoas tendon from the lesser trochanter of the femur. We emphasize the key contribution of magnetic resonance (MR) imaging to this diagnosis and provide an anatomic correlation. Spontaneous rupture of the distal iliopsoas tendon should be kept in mind in the differential diagnosis of acute groin pain in the elderly. MR imaging enables positive diagnosis, by showing mass effect on the anterior aspect of the hip joint, proximal muscle thickening, and abnormal signal intensity, and by demonstrating interruption of the psoas tendon, whereas the distal insertion of the lateral portion of the iliacus muscle remains muscular and is preserved.

  5. Spontaneous rupture of the distal iliopsoas tendon: clinical and imaging findings, with anatomic correlations

    Energy Technology Data Exchange (ETDEWEB)

    Lecouvet, Frederic E.; Vande Berg, Bruno C.; Malghem, Jacques [Universite Catholique de Louvain, Department of Radiology and Medical Imaging, Saint Luc University Hospital, Brussels (Belgium); Demondion, Xavier [Centre Hospitalier Universitaire de Lille, Department of Bone Radiology and Laboratory of Anatomy, Lille (France); Leemrijse, Thibaut [Universite Catholique de Louvain, Department of Orthopedic Surgery, Saint Luc University Hospital, Brussels (Belgium); Devogelaer, Jean-Pierre [Universite Catholique de Louvain, Department of Rheumatology, Saint Luc University Hospital, Brussels (Belgium)


    We report the clinical and imaging findings in two elderly female patients with spontaneous rupture of the distal iliopsoas tendon from the lesser trochanter of the femur. We emphasize the key contribution of magnetic resonance (MR) imaging to this diagnosis and provide an anatomic correlation. Spontaneous rupture of the distal iliopsoas tendon should be kept in mind in the differential diagnosis of acute groin pain in the elderly. MR imaging enables positive diagnosis, by showing mass effect on the anterior aspect of the hip joint, proximal muscle thickening, and abnormal signal intensity, and by demonstrating interruption of the psoas tendon, whereas the distal insertion of the lateral portion of the iliacus muscle remains muscular and is preserved. (orig.)

  6. MALDI mass spectrometry imaging: A cutting-edge tool for fundamental and clinical histopathology. (United States)

    Longuespée, Rémi; Casadonte, Rita; Kriegsmann, Mark; Pottier, Charles; Picard de Muller, Gaël; Delvenne, Philippe; Kriegsmann, Jörg; De Pauw, Edwin


    Histopathological diagnoses have been done in the last century based on hematoxylin and eosin staining. These methods were complemented by histochemistry, electron microscopy, immunohistochemistry (IHC), and molecular techniques. Mass spectrometry (MS) methods allow the thorough examination of various biocompounds in extracts and tissue sections. Today, mass spectrometry imaging (MSI), and especially matrix-assisted laser desorption ionization (MALDI) imaging links classical histology and molecular analyses. Direct mapping is a major advantage of the combination of molecular profiling and imaging. MSI can be considered as a cutting edge approach for molecular detection of proteins, peptides, carbohydrates, lipids, and small molecules in tissues. This review covers the detection of various biomolecules in histopathological sections by MSI. Proteomic methods will be introduced into clinical histopathology within the next few years.

  7. Submaximal delayed-onset muscle soreness: correlations between MR imaging findings and clinical measures (United States)

    Evans, G. F.; Haller, R. G.; Wyrick, P. S.; Parkey, R. W.; Fleckenstein, J. L.; Blomqvist, C. G. (Principal Investigator)


    PURPOSE: To assess correlations between muscle edema on magnetic resonance (MR) images and clinical indexes of muscle injury in delayed-onset muscle soreness (DOMS) produced by submaximal exercise protocols. MATERIALS AND METHODS: Sixteen subjects performed 36 elbow flexions ("biceps curls") at one of two submaximal workloads that emphasized eccentric contractions. Changes in MR imaging findings, plasma levels of creatine kinase, and pain scores were correlated. RESULTS: Both exercise protocols produced DOMS in all subjects. The best correlation was between change in creatine kinase level and volume of muscle edema on MR images, regardless of the workload. Correlations tended to be better with the easier exercise protocol. CONCLUSION: Whereas many previous studies of DOMS focused on intense exercise protocols to ensure positive results, the present investigation showed that submaximal workloads are adequate to produce DOMS and that correlations between conventionally measured indexes of injury may be enhanced at lighter exercise intensities.

  8. Is your system calibrated? MRI gradient system calibration for pre-clinical, high-resolution imaging.

    Directory of Open Access Journals (Sweden)

    James O'Callaghan

    Full Text Available High-field, pre-clinical MRI systems are widely used to characterise tissue structure and volume in small animals, using high resolution imaging. Both applications rely heavily on the consistent, accurate calibration of imaging gradients, yet such calibrations are typically only performed during maintenance sessions by equipment manufacturers, and potentially with acceptance limits that are inadequate for phenotyping. To overcome this difficulty, we present a protocol for gradient calibration quality assurance testing, based on a 3D-printed, open source, structural phantom that can be customised to the dimensions of individual scanners and RF coils. In trials on a 9.4 T system, the gradient scaling errors were reduced by an order of magnitude, and displacements of greater than 100 µm, caused by gradient non-linearity, were corrected using a post-processing technique. The step-by-step protocol can be integrated into routine pre-clinical MRI quality assurance to measure and correct for these errors. We suggest that this type of quality assurance is essential for robust pre-clinical MRI experiments that rely on accurate imaging gradients, including small animal phenotyping and diffusion MR.

  9. Naso labial cyst: presentation of a clinical case with CT and MR images

    Energy Technology Data Exchange (ETDEWEB)

    Aquilino, Raphael Navarro; Faria, Reinaldo Jose Antonio; Eid, Nayene Leocadia Manzutti; Boscolo, Frab Norberto [Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP (Brazil). Faculdade de Odontologia; Bazzo, Vitor Jose [Universidade de Sao Paulo (USP), Bauru, SP (Brazil). Faculdade de Odontologia


    The naso labial cyst is an uncommon non-odontogenic cyst that develops in the lower region of the nasal ala; its pathogenesis is uncertain. This lesion grows slowly and measures between 1.5 and 3 cm; it is characterized clinically by a floating tumefaction in the naso labial sulcus, which elevates the upper lip. The diagnosis is based on the clinical findings and, if necessary, image exams. This paper reports a case of a white 48-year-old Brazilian female patient that presented a firm tumor in the left ala of the nose; the clinical features suggested a naso labial cyst. CT scans revealed an expanding tumor with soft tissue density located in the left ala of the nose. It measured 1.2 cm in diameter and had a clear and well-defined outline; its homogeneous density was about 50 HU. MR images revealed a circular lesion located in soft tissue; T1 and T2 weighted signals were hyperintense, as were images after fat suppression. The diagnosis was a naso labial cyst, which was confirmed by histopathology after surgery. (author)

  10. Malignant round cell tumours of bone: atypical clinical and imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Saifuddin, A. [Dept. of Radiology, Royal National Orthopaedic Hospital Trust, Middlesex (United Kingdom); London Bone and Soft-tissue Tumour Service (United Kingdom); Whelan, J. [Meyerstein Inst. of Oncology, University College London Hospitals (United Kingdom); Pringle, J.A.S. [Dept. of Histopathology, Royal National Orthopaedic Hospital Trust, Middlesex (United Kingdom); Cannon, S.R. [Dept. of Orthopaedic Surgery, Royal National Orthopaedic Hospital Trust, Middlesex (United Kingdom)


    Objective. To describe the clinical, radiological and MRI features of six atypical cases of histologically proven appendicular Ewing sarcoma/ primitive neuroectodermal tumour (PNET). Design. Retrospective review of case notes and available imaging was carried out. Patients. Six patients (4 male, 2 female; mean age 27 years, range 19-44 years), presenting over a 77-month period, were identified from the Bone Tumour Register. All had unusual clinical and imaging features for Ewing sarcoma/PNET.Results and conclusions. Four tumours were centred on the distal femoral metaphysis, one in the proximal tibial metaphysis and one in the distal tibial metaphysis. Plain radiographs were available in four cases and showed minor cortical changes. MRI demonstrated a relatively small, eccentrically located intraosseous component with a large, eccentric extraosseous component. Extension into the epiphysis was seen in three cases and into the adjacent joint in two cases. Intraosseous ''skip'' metastases were present in three cases. The clinical and imaging features were atypical for conventional intraosseous Ewing sarcoma/PNET and the exact site of origin (intraosseous, periosteal or soft-tissue) was unclear. (orig.)

  11. Sparse Reconstruction Techniques in Magnetic Resonance Imaging: Methods, Applications, and Challenges to Clinical Adoption. (United States)

    Yang, Alice C; Kretzler, Madison; Sudarski, Sonja; Gulani, Vikas; Seiberlich, Nicole


    The family of sparse reconstruction techniques, including the recently introduced compressed sensing framework, has been extensively explored to reduce scan times in magnetic resonance imaging (MRI). While there are many different methods that fall under the general umbrella of sparse reconstructions, they all rely on the idea that a priori information about the sparsity of MR images can be used to reconstruct full images from undersampled data. This review describes the basic ideas behind sparse reconstruction techniques, how they could be applied to improve MRI, and the open challenges to their general adoption in a clinical setting. The fundamental principles underlying different classes of sparse reconstructions techniques are examined, and the requirements that each make on the undersampled data outlined. Applications that could potentially benefit from the accelerations that sparse reconstructions could provide are described, and clinical studies using sparse reconstructions reviewed. Lastly, technical and clinical challenges to widespread implementation of sparse reconstruction techniques, including optimization, reconstruction times, artifact appearance, and comparison with current gold standards, are discussed.

  12. Current Clinical Applications and Future Potential of Diffusion Tensor Imaging in Traumatic Brain Injury. (United States)

    Strauss, Sara; Hulkower, Miriam; Gulko, Edwin; Zampolin, Richard L; Gutman, David; Chitkara, Munish; Zughaft, Malka; Lipton, Michael L


    In the setting of acute central nervous system (CNS) emergencies, computed tomography (CT) and conventional magnetic resonance imaging (MRI) play an important role in the identification of life-threatening intracranial injury. However, the full extent or even presence of brain damage frequently escapes detection by conventional CT and MRI. Advanced MRI techniques such as diffusion tensor imaging (DTI) are emerging as important adjuncts in the diagnosis of microstructural white matter injury in the acute and postacute brain-injured patient. Although DTI aids in detection of brain injury pathology, which has been repeatedly associated with typical adverse clinical outcomes, the evolution of acute changes and their long-term prognostic implications are less clear and the subject of much active research. A major aim of current research is to identify imaging-based biomarkers that can identify the subset of TBI patients who are at risk for adverse outcome and can therefore most benefit from ongoing care and rehabilitation as well as future therapeutic interventions.The aim of this study is to introduce the current methods used to obtain DTI in the clinical setting, describe a set of common interpretation strategies with their associated advantages and pitfalls, as well as illustrate the clinical utility of DTI through a set of specific patient scenarios. We conclude with a discussion of future potential for the management of TBI.

  13. X-ray image calibration and its application to clinical orthopedics. (United States)

    Schumann, Steffen; Thelen, Benedikt; Ballestra, Steven; Nolte, Lutz-P; Büchler, Philippe; Zheng, Guoyan


    X-ray imaging is one of the most commonly used medical imaging modality. Albeit X-ray radiographs provide important clinical information for diagnosis, planning and post-operative follow-up, the challenging interpretation due to its 2D projection characteristics and the unknown magnification factor constrain the full benefit of X-ray imaging. In order to overcome these drawbacks, we proposed here an easy-to-use X-ray calibration object and developed an optimization method to robustly find correspondences between the 3D fiducials of the calibration object and their 2D projections. In this work we present all the details of this outlined concept. Moreover, we demonstrate the potential of using such a method to precisely extract information from calibrated X-ray radiographs for two different orthopedic applications: post-operative acetabular cup implant orientation measurement and 3D vertebral body displacement measurement during preoperative traction tests. In the first application, we have achieved a clinically acceptable accuracy of below 1° for both anteversion and inclination angles, where in the second application an average displacement of 8.06±3.71 mm was measured. The results of both applications indicate the importance of using X-ray calibration in the clinical routine.

  14. A robust hair segmentation and removal approach for clinical images of skin lesions. (United States)

    Huang, Adam; Kwan, Shun-Yuen; Chang, Wen-Yu; Liu, Min-Yin; Chi, Min-Hsiu; Chen, Gwo-Shing


    Artifacts such as hair are major obstacles to automatic segmentation of pigmented skin lesion images for computer-aided diagnosis systems. It is even more challenging to process clinical images taken by a regular digital camera, where the shadows of the skin texture may mimic hair-like curvilinear structures. In this study, we examined the popular DullRazor software with a dataset of 20 clinical images. The software, specifically designed for dermoscopic images, was unable to remove fine hairs or hairs in the shade. Alternatively, we proposed using conventional matched filters to enhance curvilinear structures. The more complicate hair intersection patterns, which were known to generate low matched filtering responses, were recovered by using region growing algorithms from nearby detected hair segments with linear discriminant analysis (LDA) based on a color similarity criterion. The preliminary results indicated the proposed method was able to remove more fine hairs and hairs in the shade, and lower false hair detection rate by 58% (from 0.438 to 0.183) as compared to the DullRazor's approach.

  15. Pre-clinical functional magnetic resonance imaging. Pt. I. The kidney

    Energy Technology Data Exchange (ETDEWEB)

    Zoellner, Frank G.; Kalayciyan, Raffi; Chacon-Caldera, Jorge; Zimmer, Fabian; Schad, Lothar R. [Heidelberg Univ., Mannheim (Germany). Computer Assisted Clinical Medicine


    The prevalence of chronic kidney disease (CKD) is increasing worldwide. In Europe alone, at least 8% of the population currently has some degree of CKD. CKD is associated with serious comorbidity, reduced life expectancy, and high economic costs; hence, the early detection and adequate treatment of kidney disease is important. Pre-clinical research can not only give insights into the mechanisms of the various kidney diseases but it also allows for investigating the outcome of new drugs developed to treat kidney disease. Functional magnetic resonance imaging provides non-invasive access to tissue and organ function in animal models. Advantages over classical animal research approaches are numerous: the same animal might be repeatedly imaged to investigate a progress or a treatment of disease over time. This has also a direct impact on animal welfare and the refinement of classical animal experiments as the number of animals in the studies might be reduced. In this paper, we review current state of the art in functional magnetic resonance imaging with a focus on pre-clinical kidney imaging.

  16. Hypereosinophilic syndrome: Clinical, laboratory, and imaging manifestations in patients with hepatic involvement

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Gi Beom; Lee, Jong Min; Sung, Yeong Soon; Kang, Duk Sik [Kyungpook Natioanl University College of Medicine, Daegu (Korea, Republic of); Kim, Ok Hwoa [Dongkang general Hospital, Ulsan (Korea, Republic of)


    The hypereosinophilic syndrome (HES) commonly involves liver and spleen but only a few literature has reported the imaging features. In this article, we present the imaging features of the liver and spleen in HES patients together with clinical and laboratory features. This study included 5 HES patients with hepatic involvement. Extensive laboratory tests including multiple hematologic, serologic, parasitological, and immunologic examinations were performed. Imaging studies included CT, ultrasound (US)of upper abdomen and hepatosplenic scintigraphy. All patients were periodically examined by laboratory and imaging studies for 4 to 24 months. The common clinical presentations were weakness, mild fever, and dry cough. All patients revealed leukocytosis with eosinophilia of 40 to 80% and benign eosinophilic hyperplasia of the bone marrow. The percutaneous biopsy of the hepatic focal lesions performed in 2 patients showed numerous benigin eosinophilic infiltrates and one of them revealed combined calibration necrosis of hepatocytes. All cases revealed hepatomegaly with multiple focal lesions on at least on of CT, US, or scintigraphy. These findings completely disappeared in 2 to 6 months following medication of corticosteroid or antihistamines. The HES involved the liver and CT, US, or scintigraphic studies showed hepatic multifocal lesions with hepatomegaly. Differential diagnosis of these findings should include metastatic disease, lymphoma, leukemia, candidiasis or other opportunistic infections.

  17. Imaging lobular breast carcinoma: comparison of synchrotron radiation DEI-CT technique with clinical CT, mammography and histology (United States)

    Fiedler, S.; Bravin, A.; Keyriläinen, J.; Fernández, M.; Suortti, P.; Thomlinson, W.; Tenhunen, M.; Virkkunen, P.; Karjalainen-Lindsberg, M.-L.


    Different modalities for imaging cancer-bearing breast tissue samples are described and compared. The images include clinical mammograms and computed tomography (CT) images, CT images with partly coherent synchrotron radiation (SR), and CT and radiography images taken with SR using the diffraction enhanced imaging (DEI) method. The images are evaluated by a radiologist and compared with histopathological examination of the samples. Two cases of lobular carcinoma are studied in detail. The indications of cancer are very weak or invisible in the conventional images, but the morphological changes due to invasion of cancer become pronounced in the images taken by the DEI method. The strands penetrating adipose tissue are seen clearly in the DEI-CT images, and the histopathology confirms that some strands contain the so-called 'Indian file' formations of cancer cells. The radiation dose is carefully measured for each of the imaging modalities. The mean glandular dose (MGD) for 50% glandular breast tissue is about 1 mGy in conventional mammography and less than 0.25 mGy in projection DEI, while in the clinical CT imaging the MGD is very high, about 45 mGy. The entrance dose of 95 mGy in DEI-CT imaging gives rise to an MGD of 40 mGy, but the dose may be reduced by an order of magnitude, because the contrast is very large in most images.

  18. Radiofrequency ablation of chondroblastoma: procedure technique, clinical and MR imaging follow up of four cases

    Energy Technology Data Exchange (ETDEWEB)

    Christie-Large, M.; Evans, N.; Davies, A.M.; James, S.L.J. [Royal Orthopaedic Hospital Foundation Trust, Department of Radiology, Birmingham (United Kingdom)


    The aim of this study is to describe the procedure technique, clinical and imaging outcomes of patients treated with radiofrequency ablation for chondroblastoma. Four patients (female/male, 3:1; mean age, 13 years; age range; 9-16 years) underwent the procedure. All had pre-operative magnetic resonance imaging (MRI) and symptomatic, biopsy-proven chondroblastomas (two proximal femur, two proximal tibia). The lesion size ranged from 1.5 to 2.5 cm in maximal dimension (mean size, 1.8 cm). Bone access was gained with a Bonopty biopsy needle system (mean number of radiofrequency needle placements, 5; mean ablation time, 31 min). Clinical and MRI follow-up was available in all cases (mean, 12.25 months; range, 5-18 months). All patients reported resolution of symptoms at 2-6 weeks post ablation. At their most recent clinical follow-up, three patients remained completely asymptomatic with full return to normal activities and one patient had minor local discomfort (different pain pattern) that was not limiting activity. All four patients' follow-up MRI studies demonstrated resolution of the oedema pattern around the lesion and temporal evolution of the internal signal characteristics with fatty replacement. Radiofrequency ablation for chondroblastoma provides an alternative to surgical curettage, and we have demonstrated both a clinical improvement in symptoms and the follow-up MRI appearances. (orig.)

  19. Software for MR image overlay guided needle insertions: the clinical translation process (United States)

    Ungi, Tamas; U-Thainual, Paweena; Fritz, Jan; Iordachita, Iulian I.; Flammang, Aaron J.; Carrino, John A.; Fichtinger, Gabor


    PURPOSE: Needle guidance software using augmented reality image overlay was translated from the experimental phase to support preclinical and clinical studies. Major functional and structural changes were needed to meet clinical requirements. We present the process applied to fulfill these requirements, and selected features that may be applied in the translational phase of other image-guided surgical navigation systems. METHODS: We used an agile software development process for rapid adaptation to unforeseen clinical requests. The process is based on iterations of operating room test sessions, feedback discussions, and software development sprints. The open-source application framework of 3D Slicer and the NA-MIC kit provided sufficient flexibility and stable software foundations for this work. RESULTS: All requirements were addressed in a process with 19 operating room test iterations. Most features developed in this phase were related to workflow simplification and operator feedback. CONCLUSION: Efficient and affordable modifications were facilitated by an open source application framework and frequent clinical feedback sessions. Results of cadaver experiments show that software requirements were successfully solved after a limited number of operating room tests.

  20. Qualification of NCI-Designated Cancer Centers for Quantitative PET/CT Imaging in Clinical Trials. (United States)

    Scheuermann, Joshua S; Reddin, Janet S; Opanowski, Adam; Kinahan, Paul E; Siegel, Barry A; Shankar, Lalitha K; Karp, Joel S


    The National Cancer Institute (NCI) developed the Centers for Quantitative Imaging Excellence (CQIE) initiative in 2010 to pre-qualify imaging facilities at all of the NCI-designated Comprehensive and Clinical Cancer Centers for oncology trials using advanced imaging techniques, including positron emission tomography (PET). This paper reviews the CQIE PET/CT (Computed Tomography) scanner qualification process and results in detail. Methods: Over a period of approximately 5 years, sites were requested to submit a variety of phantom, including uniform and ACR (American College of Radiology) phantoms, PET/CT images, as well as examples of clinical images. Submissions were divided into 3 distinct time points: initial submission (T0), followed by two requalification submissions (T1 and T2). Images were analyzed using standardized procedures and scanners received a pass or fail designation. Sites had the opportunity to submit new data for failed scanners. Quantitative results were compared: across scanners within a given time point and across time points for a given scanner. Results: 65 unique PET/CT scanners across 42 sites were submitted for CQIE T0 qualification, with 64 passing qualification. 44 (68%) of the scanners from T0 had data submitted for T2. From T0 to T2 the percentage of scanners passing the CQIE qualification on the first attempt rose from 38% in T1 to 67% in T2. The most common reasons for failure were: standardized uptake value (SUV) out of specifications, incomplete data submission and uniformity issues. Uniform phantom and ACR phantom results between scanner manufacturers are similar. Conclusion: The results of the CQIE process show that periodic requalification may decrease the frequency of deficient data submissions. The CQIE project also highlighted the concern within imaging facilities about the burden of maintaining different qualifications and accreditations. Finally, we note that for quantitative imaging-based trials the relationships between

  1. Intensity fluctuation analysis of cell scattering/imaging with clinical application (United States)

    Subramaniam, Raji; Sullivan, R.; Schneider, P. S.; Holden, T.; Tremberger, G., Jr.; Cheung, E.; Flamholz, A.; Lieberman, D. H.; Cheung, T. D.; Garcia, F.; Bewry, N.; Pennie, N.


    Cell scattering produces a speckle pattern, while imaging produces a contrast pattern. This family of fluctuation signals can be studied by analysis techniques such as correlation and fractal dimension. Human breast cell (normal and cancerous) samples were investigated using laser speckle and imaging microscopy. Image data from tetraploid human cell motion and quorum sensing biofilm growth were studied as well, and we found that the signal fluctuations could be interpreted as gene expression fluctuations occurring during inter-cell communication. We have mapped nucleotide sequences as images and studied the fluctuation. We showed that the fractal dimension and correlation can be used for the description of bio-information from the DNA (nanometer) scale to the tissue (millimeter) level. Fluctuations of the HAR1 nucleotide sequence and IRF-6 single-mutation cases in the van der Woude syndrome were discussed. Sub-cell structures such as the 40S ribosome, GroEL, and lysozyme, were shown to carry texture fractal dimension information in their images consistent with their biological states. Clinical applications to X-ray mammography and Parkinson disease MRI data were discussed.

  2. Molecular imaging of prostate cancer: translating molecular biology approaches into the clinical realm

    Energy Technology Data Exchange (ETDEWEB)

    Vargas, Hebert Alberto; Sala, Evis; Hricak, Hedvig [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States); Grimm, Jan [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States); Program in Molecular Pharmacology and Chemistry, Memorial Sloan Kettering Cancer Center, New York (United States); Donati, Olivio F. [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States); University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland)


    The epidemiology of prostate cancer has dramatically changed since the introduction of prostate-specific antigen (PSA) screening in the 1980's. Most prostate cancers today are detected at early stages of the disease and are considered 'indolent'; however, some patients' prostate cancers demonstrate a more aggressive behaviour which leads to rapid progression and death. Increasing understanding of the biology underlying the heterogeneity that characterises this disease has led to a continuously evolving role of imaging in the management of prostate cancer. Functional and metabolic imaging techniques are gaining importance as the impact on the therapeutic paradigm has shifted from structural tumour detection alone to distinguishing patients with indolent tumours that can be managed conservatively (e.g., by active surveillance) from patients with more aggressive tumours that may require definitive treatment with surgery or radiation. In this review, we discuss advanced imaging techniques that allow direct visualisation of molecular interactions relevant to prostate cancer and their potential for translation to the clinical setting in the near future. The potential use of imaging to follow molecular events during drug therapy as well as the use of imaging agents for therapeutic purposes will also be discussed. (orig.)

  3. Experimental and clinical studies of fast three-dimensional MR imaging of the heart

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Shuhei [Okayama Univ. (Japan). School of Medicine


    MRI has been utilized since its inception to study the anatomy and physiology of the heart. However, the sensitivity of MRI to motion has always posed a major challenge in imaging this organ. The purpose of this study was to develop a 3D MP-RAGE technique for the heart, and to apply it clinically. In the experimental study, data acquisition timing was discussed by normal volunteers. Changes in magnetization recovery time affected imaging contrast very little in the phantom study. Fourteen adults and 21 children were examined. In the adults, MP-RAGE images were rated as high in quality in the visual estimation. In the quantitative estimation, the images provided almost the same anatomical information as those of cine MRI. In the children, MP-RAGE was useful for cases of partial anomalous pulmonary venous drainage, particularly in the evaluation of abnormal pulmonary veins. The 3D MP-RAGE technique was useful in imaging the heart because it was possible to obtain continuous views in the same cardiac cycle and to reconstruct views from any direction after the examination. (author)

  4. Atlas-based neuroinformatics via MRI: harnessing information from past clinical cases and quantitative image analysis for patient care. (United States)

    Mori, Susumu; Oishi, Kenichi; Faria, Andreia V; Miller, Michael I


    With the ever-increasing amount of anatomical information radiologists have to evaluate for routine diagnoses, computational support that facilitates more efficient education and clinical decision making is highly desired. Despite the rapid progress of image analysis technologies for magnetic resonance imaging of the human brain, these methods have not been widely adopted for clinical diagnoses. To bring computational support into the clinical arena, we need to understand the decision-making process employed by well-trained clinicians and develop tools to simulate that process. In this review, we discuss the potential of atlas-based clinical neuroinformatics, which consists of annotated databases of anatomical measurements grouped according to their morphometric phenotypes and coupled with the clinical informatics upon which their diagnostic groupings are based. As these are indexed via parametric representations, we can use image retrieval tools to search for phenotypes along with their clinical metadata. The review covers the current technology, preliminary data, and future directions of this field.

  5. Effects of acquisition time and reconstruction algorithm on image quality, quantitative parameters, and clinical interpretation of myocardial perfusion imaging

    DEFF Research Database (Denmark)

    Enevoldsen, Lotte H; Menashi, Changez A K; Andersen, Ulrik B;


    BACKGROUND: Recently introduced iterative reconstruction algorithms with resolution recovery (RR) and noise-reduction technology seem promising for reducing scan time or radiation dose without loss of image quality. However, the relative effects of reduced acquisition time and reconstruction...... software have not previously been reported. The aim of the present study was to investigate the influence of reduced acquisition time and reconstruction software on quantitative and qualitative myocardial perfusion single photon emission computed tomography (SPECT) parameters using full time (FT) and half...... time (HT) protocols and Evolution for Cardiac Software. METHODS: We studied 45 consecutive, non-selected patients referred for a clinically indicated routine 2-day stress/rest (99m)Tc-Sestamibi myocardial perfusion SPECT. All patients underwent an FT and an HT scan. Both FT and HT scans were processed...

  6. A clinical gamma camera-based pinhole collimated system for high resolution small animal SPECT imaging

    Directory of Open Access Journals (Sweden)

    J. Mejia


    Full Text Available The main objective of the present study was to upgrade a clinical gamma camera to obtain high resolution tomographic images of small animal organs. The system is based on a clinical gamma camera to which we have adapted a special-purpose pinhole collimator and a device for positioning and rotating the target based on a computer-controlled step motor. We developed a software tool to reconstruct the target’s three-dimensional distribution of emission from a set of planar projections, based on the maximum likelihood algorithm. We present details on the hardware and software implementation. We imaged phantoms and heart and kidneys of rats. When using pinhole collimators, the spatial resolution and sensitivity of the imaging system depend on parameters such as the detector-to-collimator and detector-to-target distances and pinhole diameter. In this study, we reached an object voxel size of 0.6 mm and spatial resolution better than 2.4 and 1.7 mm full width at half maximum when 1.5- and 1.0-mm diameter pinholes were used, respectively. Appropriate sensitivity to study the target of interest was attained in both cases. Additionally, we show that as few as 12 projections are sufficient to attain good quality reconstructions, a result that implies a significant reduction of acquisition time and opens the possibility for radiotracer dynamic studies. In conclusion, a high resolution single photon emission computed tomography (SPECT system was developed using a commercial clinical gamma camera, allowing the acquisition of detailed volumetric images of small animal organs. This type of system has important implications for research areas such as Cardiology, Neurology or Oncology.

  7. A clinical gamma camera-based pinhole collimated system for high resolution small animal SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Mejia, J.; Galvis-Alonso, O.Y., E-mail: [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Dept. de Biologia Molecular; Castro, A.A. de; Simoes, M.V. [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Dept. de Clinica Medica; Leite, J.P. [Universidade de Sao Paulo (FMRP/USP), Ribeirao Preto, SP (Brazil). Fac. de Medicina. Dept. de Neurociencias e Ciencias do Comportamento; Braga, J. [Instituto Nacional de Pesquisas Espaciais (INPE), Sao Jose dos Campos, SP (Brazil). Div. de Astrofisica


    The main objective of the present study was to upgrade a clinical gamma camera to obtain high resolution tomographic images of small animal organs. The system is based on a clinical gamma camera to which we have adapted a special-purpose pinhole collimator and a device for positioning and rotating the target based on a computer-controlled step motor. We developed a software tool to reconstruct the target's three-dimensional distribution of emission from a set of planar projections, based on the maximum likelihood algorithm. We present details on the hardware and software implementation. We imaged phantoms and heart and kidneys of rats. When using pinhole collimators, the spatial resolution and sensitivity of the imaging system depend on parameters such as the detector-to-collimator and detector-to-target distances and pinhole diameter. In this study, we reached an object voxel size of 0.6 mm and spatial resolution better than 2.4 and 1.7 mm full width at half maximum when 1.5- and 1.0-mm diameter pinholes were used, respectively. Appropriate sensitivity to study the target of interest was attained in both cases. Additionally, we show that as few as 12 projections are sufficient to attain good quality reconstructions, a result that implies a significant reduction of acquisition time and opens the possibility for radiotracer dynamic studies. In conclusion, a high resolution single photon emission computed tomography (SPECT) system was developed using a commercial clinical gamma camera, allowing the acquisition of detailed volumetric images of small animal organs. This type of system has important implications for research areas such as Cardiology, Neurology or Oncology. (author)

  8. Registration of clinical volumes to beams-eye-view images for real-time tracking

    Energy Technology Data Exchange (ETDEWEB)

    Bryant, Jonathan H.; Rottmann, Joerg; Lewis, John H.; Mishra, Pankaj; Berbeco, Ross I., E-mail: [Department of Radiation Oncology, Brigham and Women’s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts 02115 (United States); Keall, Paul J. [Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Sydney, New South Wales 2006 (Australia)


    Purpose: The authors combine the registration of 2D beam’s eye view (BEV) images and 3D planning computed tomography (CT) images, with relative, markerless tumor tracking to provide automatic absolute tracking of physician defined volumes such as the gross tumor volume (GTV). Methods: During treatment of lung SBRT cases, BEV images were continuously acquired with an electronic portal imaging device (EPID) operating in cine mode. For absolute registration of physician-defined volumes, an intensity based 2D/3D registration to the planning CT was performed using the end-of-exhale (EoE) phase of the four dimensional computed tomography (4DCT). The volume was converted from Hounsfield units into electron density by a calibration curve and digitally reconstructed radiographs (DRRs) were generated for each beam geometry. Using normalized cross correlation between the DRR and an EoE BEV image, the best in-plane rigid transformation was found. The transformation was applied to physician-defined contours in the planning CT, mapping them into the EPID image domain. A robust multiregion method of relative markerless lung tumor tracking quantified deviations from the EoE position. Results: The success of 2D/3D registration was demonstrated at the EoE breathing phase. By registering at this phase and then employing a separate technique for relative tracking, the authors are able to successfully track target volumes in the BEV images throughout the entire treatment delivery. Conclusions: Through the combination of EPID/4DCT registration and relative tracking, a necessary step toward the clinical implementation of BEV tracking has been completed. The knowledge of tumor volumes relative to the treatment field is important for future applications like real-time motion management, adaptive radiotherapy, and delivered dose calculations.

  9. MR imaging characteristics and clinical symptoms related to displaced meniscal flap tears

    Energy Technology Data Exchange (ETDEWEB)

    Lance, Valentin; Heilmeier, Ursula R.; Joseph, Gabby B.; Steinbach, Lynne; Link, Thomas M. [University of California, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Ma, Benjamin [University of California, Department of Orthopedic Surgery and Sports Medicine, San Francisco (United States)


    The purpose of our study was (1) to analyze the flap tear location, direction of displacement and size on magnetic resonance (MR) imaging, (2) to describe associated knee abnormalities including presence of effusion, synovitis, bone marrow edema pattern or ligamentous tear, and (3) to assess clinical findings found with flap tears, including the pain score, and determine differences between operative and nonoperative groups. A retrospective radiology database search over the last 3 years identified 238 patients with flap tears, of which ultimately 58 with isolated flap tears were included after exclusion of patients with other significant knee internal derangement, severe degenerative change or prior surgery. MR studies of the knee were analyzed by two radiologists. Imaging characteristics were correlated with associated knee abnormalities and clinical findings. Statistical analysis employed linear and logistic regression models. Inter- and intrareader reliability was calculated. The medial meniscus was the most common site of flap tears (52/60, 87 %), with inferior displacement (47/60, 78 %). The degree of tibial cartilage loss had a positive correlation with the visual analog pain scale (p = 0.03). Patients who underwent arthroscopy were younger than those who did not (p = 0.01) and more likely to have a positive clinical McMurray test (p = 0.01). Medially and inferiorly displaced flap tears are the most common tear pattern. Those undergoing arthroscopy are more likely to have positive meniscal signs on clinical examination. A greater degree of cartilage loss involving the tibia on MR imaging was associated with increasing visual analog pain scores. (orig.)

  10. Clinically low-risk prostate cancer: evaluation with transrectal doppler ultrasound and functional magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Maria Inês Novis


    Full Text Available OBJECTIVES: To evaluate transrectal ultrasound, amplitude Doppler ultrasound, conventional T2-weighted magnetic resonance imaging, spectroscopy and dynamic contrast-enhanced magnetic resonance imaging in localizing and locally staging low-risk prostate cancer. INTRODUCTION: Prostate cancer has been diagnosed at earlier stages and the most accepted classification for low-risk prostate cancer is based on clinical stage T1c or T2a, Gleason score <6, and prostate-specific antigen (PSA <10 ng/ml. METHODS: From 2005 to 2006, magnetic resonance imaging was performed in 42 patients, and transrectal ultrasound in 26 of these patients. Seven patients were excluded from the study. Mean patient age was 64.94 years and mean serum PSA was 6.05 ng/ml. The examinations were analyzed for tumor identification and location in prostate sextants, detection of extracapsular extension, and seminal vesicle invasion, using surgical pathology findings as the gold standard. RESULTS: Sixteen patients (45.7% had pathologically proven organ-confined disease, 11 (31.4% had positive surgical margin, 8 (28.9% had extracapsular extension, and 3 (8.6% presented with extracapsular extension and seminal vesicle invasion. Sensitivity, specificity, positive predictive value (PPV, negative predictive value (NPV and accuracy values for localizing low-risk prostate cancer were 53.1%, 48.3%, 63.4%, 37.8% and 51.3% for transrectal ultrasound; 70.4%, 36.2%, 65.1%, 42.0% and 57.7% for amplitude Doppler ultrasound; 71.5%, 58.9%, 76.6%, 52.4% and 67.1% for magnetic resonance imaging; 70.4%, 58.7%, 78.4%, 48.2% and 66.7% for magnetic resonance spectroscopy; 67.2%, 65.7%, 79.3%, 50.6% and 66.7% for dynamic contrast-enhanced magnetic resonance imaging, respectively. Sensitivity, specificity, PPV, NPV and accuracy values for detecting extracapsular extension were 33.3%, 92%, 14.3%, 97.2% and 89.7% for transrectal ultrasound and 50.0%, 77.6%, 13.7%, 95.6% and 75.7% for magnetic resonance imaging

  11. Image Guided Clinical Correlation of CDH and Calve-Legg-Perthes Disease

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Herischi


    Full Text Available Background/Objective: Anatomic condition and"nvascularization of the femoral head leads to Calve-"nLegg-Perthes disease (avascular necrosis in children"nand primary condition of acetabulum and coverage"nof hip joint as a defect, cause CDH or congenital"ndislocation of the hip joint. Early diagnosis of these"ndiseases in clinic, confirmation by imaging (US, Xray,"nX-ray CT and MRI help better treatment and less"ncomplication or sequel."nPatients and Methods: By two decade evaluation and"ntreatment we used clinical assessments by pediatric"northopedic surgeons and radiologic examinations like"nfrog-leg, AP X-rays, ultrasound examinations, 2D"nand 3D X-ray CT and 1.5 tesla MR-machine images."nTreatments were with fixation (using cast and elizarov"nvariant fixators, surgery and controlling by imaging."nResults: Ultrasound and MRI were the best methods"nin diagnosis, image guided treatment (medical or"nsurgical and treatment controlling. Many patients"nare treated with minor complications. Complications"nare rare in CDH but some complications have been"nmentioned for CLP disease."nConclusion: Image guidance in diagnosis and treatment"nalso treatment control of pediatric CDH and CLP"ndisease give the pediatric orthopedic surgeon a good"noutcome of the disease and its treatment. Ultrasound"nand MRI using highly sophisticated probes, coils and"nprotocols with new machines gives us the best result"nin diagnosis, treatment and post-op controls.

  12. Dynamic whole-body PET parametric imaging: I. Concept, acquisition protocol optimization and clinical application. (United States)

    Karakatsanis, Nicolas A; Lodge, Martin A; Tahari, Abdel K; Zhou, Y; Wahl, Richard L; Rahmim, Arman


    Static whole-body PET/CT, employing the standardized uptake value (SUV), is considered the standard clinical approach to diagnosis and treatment response monitoring for a wide range of oncologic malignancies. Alternative PET protocols involving dynamic acquisition of temporal images have been implemented in the research setting, allowing quantification of tracer dynamics, an important capability for tumor characterization and treatment response monitoring. Nonetheless, dynamic protocols have been confined to single-bed-coverage limiting the axial field-of-view to ~15-20 cm, and have not been translated to the routine clinical context of whole-body PET imaging for the inspection of disseminated disease. Here, we pursue a transition to dynamic whole-body PET parametric imaging, by presenting, within a unified framework, clinically feasible multi-bed dynamic PET acquisition protocols and parametric imaging methods. We investigate solutions to address the challenges of: (i) long acquisitions, (ii) small number of dynamic frames per bed, and (iii) non-invasive quantification of kinetics in the plasma. In the present study, a novel dynamic (4D) whole-body PET acquisition protocol of ~45 min total length is presented, composed of (i) an initial 6 min dynamic PET scan (24 frames) over the heart, followed by (ii) a sequence of multi-pass multi-bed PET scans (six passes × seven bed positions, each scanned for 45 s). Standard Patlak linear graphical analysis modeling was employed, coupled with image-derived plasma input function measurements. Ordinary least squares Patlak estimation was used as the baseline regression method to quantify the physiological parameters of tracer uptake rate Ki and total blood distribution volume V on an individual voxel basis. Extensive Monte Carlo simulation studies, using a wide set of published kinetic FDG parameters and GATE and XCAT platforms, were conducted to optimize the acquisition protocol from a range of ten different clinically

  13. Growth hormone-secreting pituitary adenoma:clinical and MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hong Suk; Chang, Kee Hyun; Han, Moon Hee; Sim, Jung Suk; Lee, Sang Hyun; Song, Jae Uoo; Yoo, In Kyu; Jung, Hee Won; Yeon, Kyung Mo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)


    To describe clinical and MRI findings of growth hormone-secreting pituitary adenoma, to determine if there are any characteristic MRI findings different from those of other pituitary adenomas, to evaluate the relationship between tumor size and serum growth hormone level, and to assess the results of immunohi-stochemical study. We retrospectively analysed clinical and MRI findings of 29 patients with growth hormone-secreting pituitary adenoma confirmed by serum growth hormone level and surgery. We also evaluated the relationship between the tumor volume and serum growth hormone level, and the results of immunohistochemical study. Coronal and sagittal T1-weighted MR images in all patients and gadolinium-enhanced T1-weighted MR images in 28 patients were obtained with 2.0 T(24 cases) and 0.5 T(5 cases) MR imagers. The images were analyzed in terms of tumor size, signal intensity, degree of contrast enhancement, extent of tumor growth and the presence or absence of cystic change, hemorrhage and calcification. Clinical manifestations included facial feature change and soft tissue swelling of hands and feet(n=29), headache(n=12), impaired visual acuity(n=9), symptoms of hyperprolactinemia(n=8), visual field defect(n=5), and others(n=6). On MR images, all of the 29 cases were seen to be macroadenomas and the size of the tumors averaged 2.2cm(1-5.2cm). Supra- and infrasellar extensions were seen in 21 and 22 patients, respectively. Cavernous sinus invasion was noted in seven, and in one this was bilateral. Signal intensity was isointense with cortical grey matter in 26 cases(90%). Cystic change or necrosis was seen in eight cases(28%), hemorrhage in four(14%), and calcification in two(7%). After enhancement, most(25/28) of the tumors enhanced less than normal pituitary in degree. There was no correlation between serum growth hormone level and tumor size. Immunohistochemical study showed positive growth hormone-secreting pituitary adenomas were various and included

  14. Ultra high field magnetic resonance imaging; L'imagerie par resonance magnetique a ultra-haut champ. L'aimant, piece maitresse de l'imageur. Memo C: les principales techniques d'imagerie medicale

    Energy Technology Data Exchange (ETDEWEB)

    Lethimonnier, F. [CEA Saclay, Institut d' Imagerie Biomedicale - NeuroSpin, Dir. des Sciences du Vivant, 91 - Gif-sur-Yvette (France); Vedrine, P. [CEA Saclay, Direction des Sciences de la Matiere, 91 - Gif-sur-Yvette (France)


    Understanding human brain function, brain development and brain dysfunction is one of the great challenges of the twenty first century. Biomedical imaging has now run up against a number of technical constraints that are exposing limits to its potential. In order to overcome the current limits to high-field magnetic resonance cerebral imaging (MRI) and unleash its fullest potential, the Cea has built NeuroSpin, an ultra-high-field neuroimaging facility at its Saclay centre (in the Essonne). NeuroSpin already boasts three fully operational MRI systems. The first is a 3-tesla high-field system and the second is a very-high-field 7-tesla system, both of which are dedicated to clinical studies and investigations in humans, while the third is an ultra-high-field 17.65-tesla system designed for studies on small animals. In 2011, NeuroSpin will be commissioning an 11.7-tesla ultra-high-field system of unprecedented power that is designed for research on human subjects. The level of the magnetic field and the scale required will make this joint French-German project to build the magnet a breakthrough in the international arena. (authors)

  15. Subchondral insufficiency fractures of the femoral head: associated imaging findings and predictors of clinical progression

    Energy Technology Data Exchange (ETDEWEB)

    Hackney, Lauren A.; Joseph, Gabby B.; Link, Thomas M. [University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); Lee, Min Hee [University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States); University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul (Korea, Republic of); Vail, Thomas P. [University of California, Department of Orthopaedic Surgery, San Francisco, CA (United States)


    To characterize the morphology and imaging findings of femoral head subchondral insufficiency fractures (SIF), and to investigate clinical outcomes in relation to imaging findings. Fifty-one patients with hip/pelvis magnetic resonance (MR) images and typical SIF characteristics were identified and reviewed by two radiologists. Thirty-five patients had follow-up documentation allowing assessment of clinical outcome. Subgroup comparisons were performed using regression models adjusted for age and body mass index. SIF were frequently associated with cartilage loss (35/47, 74.5 %), effusion (33/42, 78.6 %), synovitis (29/44, 66 %), and bone marrow oedema pattern (BMEP) (average cross-sectional area 885.7 ± 730.2 mm{sup 2}). Total hip arthroplasty (THA) was required in 16/35 patients, at an average of 6 months post-MRI. Compared to the THA cohort, the non-THA group had significantly (p < 0.05) smaller overlying cartilage defect size (10 mm vs. 29 mm), smaller band length ratio and fracture diameters, and greater incidence of parallel fracture morphology (p < 0.05). Male gender and increased age were significantly associated with progression, p < 0.05. SIF were associated with synovitis, cartilage loss, effusion, and BMEP. Male gender and increased age had a significant association with progression to THA, as did band length ratio, fracture diameter, cartilage defect size, and fracture deformity/morphology. (orig.)

  16. Biomechanical Role of Bone Anisotropy Estimated on Clinical CT Scans by Image Registration. (United States)

    Taghizadeh, Elham; Reyes, Mauricio; Zysset, Philippe; Latypova, Adeliya; Terrier, Alexandre; Büchler, Philippe


    Image-based modeling is a popular approach to perform patient-specific biomechanical simulations. Accurate modeling is critical for orthopedic application to evaluate implant design and surgical planning. It has been shown that bone strength can be estimated from the bone mineral density (BMD) and trabecular bone architecture. However, these findings cannot be directly and fully transferred to patient-specific modeling since only BMD can be derived from clinical CT. Therefore, the objective of this study was to propose a method to predict the trabecular bone structure using a µCT atlas and an image registration technique. The approach has been evaluated on femurs and patellae under physiological loading. The displacement and ultimate force for femurs loaded in stance position were predicted with an error of 2.5% and 3.7%, respectively, while predictions obtained with an isotropic material resulted in errors of 7.3% and 6.9%. Similar results were obtained for the patella, where the strain predicted using the registration approach resulted in an improved mean squared error compared to the isotropic model. We conclude that the registration of anisotropic information from of a single template bone enables more accurate patient-specific simulations from clinical image datasets than isotropic model.

  17. Clinical practice of image-guided spine radiosurgery - results from an international research consortium

    Directory of Open Access Journals (Sweden)

    Guckenberger Matthias


    Full Text Available Abstract Background Spinal radiosurgery is a quickly evolving technique in the radiotherapy and neurosurgical communities. However, the methods of spine radiosurgery have not been standardized. This article describes the results of a survey about the methods of spine radiosurgery at five international institutions. Methods All institutions are members of the Elekta Spine Radiosurgery Research Consortium and have a dedicated research and clinical focus on image-guided radiosurgery. The questionnaire consisted of 75 items covering all major steps of spine radiosurgery. Results Strong agreement in the methods of spine radiosurgery was observed. In particular, similarities were observed with safety and quality assurance playing an important role in the methods of all institutions, cooperation between neurosurgeons and radiation oncologists in case selection, dedicated imaging for target- and organ-at-risk delineation, application of proper safety margins for the target volume and organs-at-risk, conformal planning and precise image-guided treatment delivery, and close clinical and radiological follow-up. In contrast, three major areas of uncertainty and disagreement were identified: 1 Indications and contra-indications for spine radiosurgery; 2 treatment dose and fractionation and 3 tolerance dose of the spinal cord. Conclusions Results of this study reflect the current practice of spine radiosurgery in large academic centers. Despite close agreement was observed in many steps of spine radiosurgery, further research in form of retrospective and especially prospective studies is required to refine the details of spinal radiosurgery in terms of safety and efficacy.

  18. Clinical manifestation, imaging, and genotype analysis of two pedigrees with spinocerebellar ataxia. (United States)

    Peipei, Liu; Yang, Liu; Weihong, Gu; Xiaonan, Song


    The objective of this study was to analyze the clinical manifestation, imaging characteristics, genotype, and the relationship between the three aforementioned parameters in two pedigrees suffering from spinocerebellar ataxia. To evaluate the clinical manifestation of the two pedigrees and to compare the characteristics, we performed the MRI analysis of some patients from both pedigrees, while 2 ml of the peripheral blood sample was collected for gene analysis. The gene analysis data showed that pedigree 1 was certified spinocerebellar ataxia type-2 (SCA2); the CAG repeats in the proband, proband's mother, and proband's brother were 44, 36, and 38, respectively. The MRI revealed brainstem cerebellar atrophy and "cross sign" and "ordinate sign" of pons. Pedigree 2 was certified SCA1; the CAG repeats of the proband, proband's aunt, and proband's asymptomatic cousin were 60, 51, and 52, respectively. The MRI revealed cerebellar atrophy in these individuals. We, therefore, concluded that it was difficult to diagnose the SCA subset solely through the clinical manifestation. The imaging characteristics analysis and final diagnosis depended basically on gene analysis data.

  19. ESGAR consensus statement on liver MR imaging and clinical use of liver-specific contrast agents

    Energy Technology Data Exchange (ETDEWEB)

    Neri, E.; Boraschi, P.; Bartolozzi, C. [University of Pisa, Department of Diagnostic and Interventional Radiology, Pisa (Italy); Bali, M.A.; Matos, C. [Hopital Erasme, MRI Clinics, Department of Radiology, Bruxelles (Belgium); Ba-Ssalamah, A. [The General Hospital of the Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Brancatelli, G. [University of Palermo, Department of Radiology, Palermo (Italy); Alves, F.C. [University Hospital of Coimbra, Medical Imaging Department and Faculty of Medicine, Coimbra (Portugal); Grazioli, L. [Spedali Civili di Brescia, Department of Radiology, Brescia (Italy); Helmberger, T. [Academic Teaching Hospital of the Technical University, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Klinikum Bogenhausen, Munich (Germany); Lee, J.M. [Seoul National University College of Medicine, Division of Abdominal Imaging, Department of Radiology, Seoul (Korea, Republic of); Manfredi, R. [University of Verona, Department of Radiology, Verona (Italy); Marti-Bonmati, L. [Hospital Universitario y Politecnico La Fe, Area Clinica de Imagen Medica, Valencia (Spain); Merkle, E.M. [Universitaetsspital Basel, Klinik fuer Radiologie und Nuklearmedizin, Basel (Switzerland); Op De Beeck, B. [Antwerp University Hospital, Department of Radiology, Edegem (Belgium); Schima, W. [KH Goettlicher Heiland, Krankenhaus der Barmherzigen Schwestern and Sankt Josef-Krankenhaus, Department of Diagnostic and Interventional Radiology, Vienna (Austria); Skehan, S. [St Vincent' s University Hospital, Department of Radiology, Dublin (Ireland); Vilgrain, V. [Assistance Publique-Hopitaux de Paris, APHP, Hopital Beaujon, Radiology Department, Clichy, Paris (France); Zech, C. [Universitaetsspital Basel, Abteilungsleiter Interventionelle Radiologie, Klinik fuer Radiologie und Nuklearmedizin, Basel (Switzerland)


    To develop a consensus and provide updated recommendations on liver MR imaging and the clinical use of liver-specific contrast agents. The European Society of Gastrointestinal and Abdominal Radiology (ESGAR) formed a multinational European panel of experts, selected on the basis of a literature review and their leadership in the field of liver MR imaging. A modified Delphi process was adopted to draft a list of statements. Descriptive and Cronbach's statistics were used to rate levels of agreement and internal reliability of the consensus. Three Delphi rounds were conducted and 76 statements composed on MR technique (n = 17), clinical application of liver-specific contrast agents in benign, focal liver lesions (n = 7), malignant liver lesions in non-cirrhotic (n = 9) and in cirrhotic patients (n = 18), diffuse and vascular liver diseases (n = 12), and bile ducts (n = 13). The overall mean score of agreement was 4.84 (SD ±0.17). Full consensus was reached in 22 % of all statements in all working groups, with no full consensus reached on diffuse and vascular diseases. The consensus provided updated recommendations on the methodology, and clinical indications, of MRI with liver specific contrast agents in the study of liver diseases. (orig.)

  20. Linking restless legs syndrome with Parkinson's disease: clinical, imaging and genetic evidence

    Directory of Open Access Journals (Sweden)

    Peeraully Tasneem


    Full Text Available Abstract Restless legs syndrome (RLS and Parkinson's disease (PD are both common neurological disorders. There has been much debate over whether an etiological link between these two diseases exists and whether they share a common pathophysiology. Evidence pointing towards a link includes response to dopaminergic agents in PD and RLS, suggestive of underlying dopamine dysfunction in both conditions. The extrastriatal dopaminergic system, in particular altered spinal dopaminergic modulation, may be variably involved in PD patients with RLS symptoms. In addition, there is now evidence that the nigrostriatal system, primarily involved in PD, is also affected in RLS. Furthermore, an association of RLS with the parkin mutation has been suggested. The prevalence of RLS has also been reported to be increased in other disorders of dopamine regulation. However, clinical association studies and functional imaging have produced mixed findings. Conflicting accounts of emergence of RLS and improvement in RLS symptoms after deep brain stimulation (DBS also contribute to the uncertainty surrounding the issue. Among the strongest arguments against a common pathophysiology is the role of iron in RLS and PD. While elevated iron levels in the substantia nigra contribute to oxidative stress in PD, RLS is a disorder of relative iron deficiency, with symptoms responding to replacement therapy. Recent ultrasonography studies have suggested that, despite overlapping clinical features, the mechanisms underlying idiopathic RLS and RLS associated with PD may differ. In this review, we provide a concise summary of the clinical, imaging and genetic evidence exploring the link between RLS and PD.

  1. Digital management and regulatory submission of medical images from clinical trials: role and benefits of the core laboratory (United States)

    Robbins, William L.; Conklin, James J.


    Medical images (angiography, CT, MRI, nuclear medicine, ultrasound, x ray) play an increasingly important role in the clinical development and regulatory review process for pharmaceuticals and medical devices. Since medical images are increasingly acquired and archived digitally, or are readily digitized from film, they can be visualized, processed and analyzed in a variety of ways using digital image processing and display technology. Moreover, with image-based data management and data visualization tools, medical images can be electronically organized and submitted to the U.S. Food and Drug Administration (FDA) for review. The collection, processing, analysis, archival, and submission of medical images in a digital format versus an analog (film-based) format presents both challenges and opportunities for the clinical and regulatory information management specialist. The medical imaging 'core laboratory' is an important resource for clinical trials and regulatory submissions involving medical imaging data. Use of digital imaging technology within a core laboratory can increase efficiency and decrease overall costs in the image data management and regulatory review process.

  2. Clinical utility and reliability of sup(81m)Kr SPECT images applied to posterior circulation

    Energy Technology Data Exchange (ETDEWEB)

    Yoshizawa, Takashi; Kikuchi, Haruhiko; Karasawa, Jun (National Cardiovascular Center, Suita, Osaka (Japan))


    The instrument used in this study has a sensitivity of 28,000 counts/mCi/cm/sup 3/ for sup(99m)Tc and a spatial resolution of approximately 20mm full width at a half-maximum. The tomographic images were obtained by the continuous infusion of sup(81m)Kr at the base of the ascending aorta. Material was subsequently studied in 49 cases that met the conditions of: 1) obstructive vertebrobasilar system lesions (8 cases), 2) no ischemic cerebrovascular diseases (10), or 3) ischemic cerebrovascular disorders in anterior circulation (31). The reproducibility, as studied in 20 cases, was satisfactory. 6 cases were compared with a stable Xe CT CBF map that had regional depressions similar to those of the sup(81m)Kr SPECT images. In the 2nd group, 8 of the 10 cases showed a mild laterality on cerebellar perfusion images obtained by SPECT, as did 29 of the 31 in the 3rd group; among them, 2 cases with a recently completed stroke revealed a marked depression in the ipsilateral cerebellar hemisphere to the side of the hemiplegia. Cases of the lst group showed generally depressed perfusion images of the brain stem or cerebellum, and the low-density areas of X-ray CT were comparable to the lower perfusional regions on SPECT. The authors concluded that posterior perfusion images obtained by sup(81m)Kr SPECT were affected by occlusive vertebrobasilar-system lesions as well as by carotid-system lesions and cerebellar functions, and that this method for evaluating hemodynamics will be of much more clinical use in repeated studies to demonstrate the changes in posterior ciculation in course or by some loadings with subclinical characteristics, for this paper includes the first report on cerebellar functional images, though it is restricted by the low-spatial resolution from defining the architecture of the posterior fossa in detail.

  3. Ischaemic memory imaging using metabolic radiopharmaceuticals: overview of clinical settings and ongoing investigations

    Energy Technology Data Exchange (ETDEWEB)

    Yoshinaga, Keiichiro [Hokkaido University Graduate School of Medicine, Department of Molecular Imaging, Sapporo (Japan); Naya, Masanao [Hokkaido University Graduate School of Medicine, Department of Cardiology, Sapporo (Japan); Shiga, Tohru; Suzuki, Eriko; Tamaki, Nagara [Hokkaido University Graduate School of Medicine, Department of Nuclear Medicine, Sapporo (Japan)


    ''Ischaemic memory'' is defined as a prolonged functional and/or biochemical alteration remaining after a particular episode of severe myocardial ischaemia. The biochemical alteration has been reported as metabolic stunning. Metabolic imaging has been used to detect the footprint left by previous ischaemic episodes evident due to delayed recovery of myocardial metabolism (persistent dominant glucose utilization with suppression of fatty acid oxidation). β-Methyl-p-[{sup 123}I]iodophenylpentadecanoic acid (BMIPP) is a single-photon emission computed tomography (SPECT) radiotracer widely used for metabolic imaging in clinical settings in Japan. In patients with suspected coronary artery disease but no previous myocardial infarction, BMIPP has shown acceptable diagnostic accuracy. In particular, BMIPP plays an important role in the identification of prior ischaemic insult in patients arriving at emergency departments with acute chest pain syndrome. Recent data also show the usefulness of {sup 123}I-BMIPP SPECT for predicting cardiovascular events in patients undergoing haemodialysis. Similarly, SPECT or PET imaging with {sup 18}F-FDG injected during peak exercise or after exercise under fasting conditions shows an increase in FDG uptake in postischaemic areas. This article will overview the roles of ischaemic memory imaging both under established indications and in ongoing investigations. (orig.)

  4. Image De-Identification Methods for Clinical Research in the XDS Environment. (United States)

    Aryanto, K Y E; van Kernebeek, G; Berendsen, B; Oudkerk, M; van Ooijen, P M A


    To investigate possible de-identification methodologies within the Cross-Enterprise Document Sharing for imaging (XDS-I) environment in order to provide strengthened support for image data exchange as part of clinical research projects. De-identification, using anonymization or pseudonymization, is the most common method to perform information removal within DICOM data. However, it is not a standard part of the XDS-I profiles. Different methodologies were observed to define how and where de-identification should take place within an XDS environment used for scientific research. De-identification service can be placed in three locations within the XDS-I framework: 1) within the Document Source, 2) between the Document Source and Document Consumer, and 3) within the Document Consumer. First method has a potential advantage with respect to the exposure of the images to outside systems but has drawbacks with respect to additional hardware and configuration requirements. Second and third method have big concern in exposing original documents with all identifiable data being intact after leaving the Document Source. De-identification within the Document Source has more advantages compared to the other methods. On the contrary, it is less recommended to perform de-identification within the Document Consumer since it has the highest risk of the exposure of patients identity due to the fact that images are exposed without de-identification during the transfers.

  5. Imaging as component of clinical tumor staging; Bildgebung als Teil des klinischen Tumorstagings

    Energy Technology Data Exchange (ETDEWEB)

    Brodowicz, T. [Klinische Abt. fuer Onkologie, Universitaetskliniken Wien (Austria); Zielinski, C.C. [Klinische Abt. fuer Onkologie, Universitaetskliniken Wien (Austria)]|[Extraordinariat fuer Internistisch-Experimentelle Onkologie, Universitaetskliniken Wien (Austria)]|[Ludwig Boltzmann Inst. fuer Klinisch Experimentelle Onkologie, Wien (Austria)


    In order to evaluate the anatomic extension of neoplastic disease according to the TNM system sufficiently, inclusion of imaging techniques is absolutely necessary. In addition, decisions on further clinical processing are based on precise identification of primary tumor extent (T), condition of regional nodes (N) and possible presence of distant metastases (M). Breast cancer, lung cancer, colorectal cancer and prostate cancer represent the most common tumor entities. Within this context the importance of imaging techniques for diagnosis, prognosis, therapy and follow-up of patients with these malignancies is presented in this report. (orig.) [Deutsch] Ein adaequates, das weitere klinische Procedere bestimmende Tumorstaging nach dem TNM-System, sprich die Evaluierung der Primaertumorgroesse (T), des Ausmasses des Lymphknotenbefalls (N) sowie einer eventuell vorhandenen Fernmetastasierung (M) ist nur durch Inkludierung der Bildgebung moeglich. Anhand der haeufigsten Tumorentitaeten - dem Mammakarzinom, Bronchialkarzinom, Prostatakarzinom sowie dem kolorektalen Karzinom - wird die Bedeutung der BBildgebung fuer Diagnose, Prognose, Therapie und letztendlich Nachsorge erlaeutert. (orig.)

  6. MR imaging in clinically suspected acute cholecystitis: a comparison with ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Haakansson, K. [Kalmar Hospital (Sweden). Dept. of Radiology; Leander, P.; Ekberg, O. [Malmoe Univ. Hospital (Sweden). Dept. of Radiology; Haakansson, H.O. [Kalmar Hospital (Sweden). Dept. of Surgery


    Purpose: The diagnostic value of fast pulse sequences in MR imaging was compared with US in patients with clinically suspected acute cholecystitis. Material and Methods: In a prospective study of 94 patients, 35 were examined with both MR and US within 24 h. Results: MR diagnoses were acute cholecystitis in 23, gallbladder and common bile duct stones in 3, other pathologic conditions of the abdomen in 7 and normal in 2 patients. US diagnoses were acute cholecystitis in 17, gallbladder stones in 8, other pathologic conditions of the abdomen in 2, normal in 5 and non-conclusive in 3 patients. Conclusion: MR has a higher sensitivity than US for diagnosing acute cholecystitis and, with increased accessibility (may be the first imaging method)

  7. Clinical NMR imaging of the brain in children: normal and neurologic disease

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, M.A, (Hammersmith Hospital, London, England); Pennock, J.M.; Bydder, G.M.; Steiner, R.E.; Thomas, D.J.; Hayward, R.; Bryant, D.R.T.; Payne, J.A.; Levene, M.I.; Whitelaw, A.; Dubowitz, L.M.S.; Dubowitz, V.


    The results of initial clinical nuclear magnetic resonance imaging of the brain in eight normal and 52 children with a wide variety of neurologic diseases were reviewed. The high level of gray-white matter contrast available with inversion-recovery sequences provided a basis for visualizing normal myelination as well as delays or deficits in this process. The appearances seen in cases of parenchymal hemorrhage, cerebral infarction, and proencephalic cysts are described. Ventricular enlargement was readily identified and marginal edema was demonstrated with spin-echo sequences. Abnormalities were seen in cerebral palsy, congenital malformations, Hallervorden-Spatz disease, aminoaciduria, and meningitis. Space-occupying lesions were identified by virtue of their increased relaxation times and mass effects. Nuclear magnetic resonance imaging has considerable potential in pediatric neuroradiologic practice, in some conditions supplying information not available by computed tomography or sonography.

  8. PET Radiopharmaceuticals for Imaging Integrin Expression: Tracers in Clinical Studies and Recent Developments

    Directory of Open Access Journals (Sweden)

    Roland Haubner


    Full Text Available Noninvasive determination of integrin expression has become an interesting approach in nuclear medicine. Since the discovery of the first 18F-labeled cyclic RGD peptide as radiotracer for imaging integrin αvβ3 expression in vivo, there have been carried out enormous efforts to develop RGD peptides for PET imaging. Moreover, in recent years, additional integrins, including α5β1 and αvβ6, came into the focus of pharmaceutical radiochemistry. This review will discuss the tracers already evaluated in clinical trials and summarize the preliminary outcome. It will also give an overview on recent developments to further optimize the first-generation compounds such as [18F]Galacto-RGD. This includes recently developed 18F-labeling strategies and also new approaches in 68Ga-complex chemistry. Furthermore, the approaches to develop radiopharmaceuticals targeting integrin α5β1 and αvβ6 will be summarized and discussed.

  9. Clinical PET/MR Imaging in Dementia and Neuro-Oncology

    DEFF Research Database (Denmark)

    Mølby Henriksen, Otto; Marner, Lisbeth; Law, Ian


    The introduction of hybrid PET/MRI systems allows simultaneous multimodality image acquisition of high technical quality. This technique is well suited for the brain, and particularly in dementia and neuro-oncology. In routine use combinations of well-established MRI sequences and PET tracers....../MRI using [18F]-fluoro-ethyl-tyrosine (FET) also abide to the expectations of the adaptive and versatile diagnostic tool necessary in neuro-oncology covering both simple 20 min protocols for routine treatment surveillance and complicated 90 min brain and spinal cord protocols in pediatric neuro......-oncology under general anesthesia. The clinical value of adding advanced MRI sequences in multiparametric imaging setting, however, is still undocumented....

  10. Molecular breast imaging: First results from Italian-National-Institute-of-Health clinical trials (United States)

    Cusanno, F.; Cisbani, E.; Colilli, S.; Fratoni, R.; Garibaldi, F.; Giuliani, F.; Gricia, M.; Lucentini, M.; Magliozzi, M. L.; Santanvenere, F.; Torrioli, S.; Cinti, M. N.; Pani, R.; Pellegrini, R.; Simonetti, G.; Schillaci, O.; Del Vecchio, S.; Salvatore, M.; Majewski, S.; De Vincentis, G.; Scopinaro, F.


    Dedicated high resolution detectors are needed for detection of small tumors by molecular imaging with radionuclides. Absorptive collimation are typically used for imaging single photon emitters, but it results in a strong reduction in efficiency. Systems based on electronic collimation offer higher efficiency but they are complex and expensive. In case of scintimammography, dual-head detectors increase sensitivity and cancel out the dependence of the lesion depth. In the system presented here, pixellated scintillator arrays (NaI:Tl) were coupled to arrays of PSPMT's, HPK H8500 Flat Panel. A dual-head detector having field of view of 100×100 mm 2 and 150×200 mm 2 were designed and built. The electronic system allows readout of all the anode pad signals. First clinical trials, performed in the framework of the Scintimammography project of Italian National Institute of Health and University of Tor Vergata in Rome, and University of Naples, are presented.

  11. Infant Hip Joint Diagnostic Support System Based on Clinical Manifestations in X-ray Images

    Directory of Open Access Journals (Sweden)



    Full Text Available Plain X-ray radiography is frequently used for the diagnosis of developmental dislocation of the hip (DDH. The aim of this study was to construct a diagnostic support system for DDH based on clinical findings obtained from the X-ray images of 154 female infants with confirmed diagnoses made by orthopedists. The data for these subjects were divided into 2 groups. The Min-Max method of nonlinear analysis was applied to the data from Group 1 to construct the diagnostic support system based on the measurement of 4 items in X-ray images:the outward displacement rate, upward displacement rate, OE angle, and alpha angle. This system was then applied to the data from Group 2, and the results were compared between the 2 groups to verify the reliability of the system. We obtained good results that matched the confirmed diagnoses of orthopedists with an accuracy of 85.9%.

  12. Doppler standard deviation imaging for clinical monitoring of in vivo human skin blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Yonghua; Chen, Zhongping; Saxer, Christopher; Shen, Qimin; Xiang, Shaohua; Boer, Johannes F. de; Nelson, J. Stuart


    We used a novel phase-resolved optical Doppler tomographic (ODT) technique with very high flow-velocity sensitivity (10 {mu}m/s) and high spatial resolution (10 {mu}m) to image blood flow in port-wine stain (PWS) birthmarks in human skin. In addition to the regular ODT velocity and structural images, we use the variance of blood flow velocity to map the PWS vessels. Our device combines ODT and therapeutic systems such that PWS blood flow can be monitored in situ before and after laser treatment. To the authors' knowledge this is the first clinical application of ODT to provide a fast semiquantitative evaluation of the efficacy of PWS laser therapy in situ and in real time. (c) 2000 Optical Society of America.

  13. Imaging and clinical findings in large endolymphatic duct and sac syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Koesling, Sabrina [University of Halle, Department of Radiology, E-Grube-Street 40, D-06097 Halle (Germany)]. E-mail:; Rasinski, Christine [University of Halle, Department of Otorhinolaryngology (Germany); Amaya, Beatrice [University of Halle, Department of Radiology, E-Grube-Street 40, D-06097 Halle (Germany)


    Objective: Large endolymphatic duct and sac syndrome (LEDS) is known as the most common kind of inner ear malformations, which is radiologically detectable. Nevertheless, nowadays many questions are not fully cleared and LEDS is relatively unknown among general radiologists. The aim of this study was to evaluate the incidence of LEDS in the own patient population and to present our experiences regarding imaging findings, clinical presentation and follow up. Materials and methods: Based on a complete recording of all patients, sent from ENT department to radiology, we identified all radiological diagnosed cases of inner ear malformations including LEDS and all patients in whom an inner ear malformation was clinically suspected. The retrospective study included clinical records, HR-CT and MRI performed between 1994 and 2002. Results: Among 169 patients (338 ear), 17 of patients (median age: 12 years) and 28 ears, respectively, had enlarged endolymphatic structures. In 10 patients - 6% - (15 ears), no other abnormalities were detected, called isolated LEDS, seven patients showed additional inner ear abnormalities. One patient showed a labyrinthine hemorrhage after sudden hearing loss. Audiometric data revealed sensorineural hearing loss in 22 ears, deafness in 5 ears and normal hearing in 1 case of 28 ears. In 10 (67%) of 15 ears with isolated LEDS, the hearing loss was downward-fluctuating progressive. Twelve patients (eight with isolated LEDS) had partly repeated sudden hearing losses. A trigger for worsening of hearing was found in five patients. A correlation between the severity of morphological changes on imaging and the degree of hearing disturbances could not be detected. Only four young patients underwent a radiological examination within the first or second year after onset of hearing loss. Three patients received a cochlear implant. Conclusions: LEDS might be the cause of progressive hearing loss and repeated acute hearing losses in children and young

  14. Clinical usefulness of facial soft tissues thickness measurement using 3D computed tomographic images

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Ho Gul; Kim, Kee Deog; Hu, Kyung Seok; Lee, Jae Bum; Park, Hyok [Maxtron Inc., Seoul (Korea, Republic of); Han, Seung Ho [Catholic Univ. of Korea, Seoul (Korea, Republic of); Choi, Seong Ho; Kim, Chong Kwan; Park, Chang Seo [Yonsei Univ., Seoul (Korea, Republic of)


    To evaluate clinical usefulness of facial soft tissue thickness measurement using 3D computed tomographic images. One cadaver that had sound facial soft tissues was chosen for the study. The cadaver was scanned with a Helical CT under following scanning protocols about slice thickness and table speed: 3 mm and 3 mm/sec, 5 mm and 5 mm/sec, 7 mm and 7 mm/sec. The acquired data were reconstructed 1.5, 2.5, 3.5 mm reconstruction interval respectively and the images were transferred to a personal computer. Using a program developed to measure facial soft tissue thickness in 3D image, the facial soft tissue thickness was measured. After the ten-time repeation of the measurement for ten times, repeated measure analysis of variance (ANOVA) was adopted to compare and analyze the measurements using the three scanning protocols. Comparison according to the areas was analysed by Mann-Whitney test. There were no statistically significant intraobserver differences in the measurements of the facial soft tissue thickness using the three scanning protocols (p>0.05). There were no statistically significant differences between measurements in the 3 mm slice thickness and those in the 5 mm, 7 mm slice thickness (p>0.05). There were statistical differences in the 14 of the total 30 measured points in the 5 mm slice thickness and 22 in the 7 mm slice thickness. The facial soft tissue thickness measurement using 3D images of 7 mm slice thickness is acceptable clinically, but those of 5 mm slice thickness is recommended for the more accurate measurement.

  15. A 12 month clinical audit of cervical spine imaging in multiply injured and intubated patients. (United States)

    Ball, C; Watson, D


    Previous work has questioned how plain films should be used when imaging the cervical spine of trauma patients. The authors wanted to identify whether the National Institute for Clinical Excellence (NICE) guidelines were being followed with respect to the imaging of patients presenting with cervical spine injury over a 1 year period. Data retrieved from the Electronic Digital Information Service (EDIS) computerised database records of all patients presenting with a triage code 1 or 2 between 1 September 2007 and 31 August 2008 were used to conduct a retrospective audit that identified multiply injured and intubated patients who did not undergo CT of the cervical spine and to highlight the use of plain films when the patient was to undergo CT of the head and cervical spine. A clinical record search identified 52 patients with a mean age of 32 years, of whom 73% were males, who had been admitted with multiple traumas and had undergone imaging of the cervical spine. Although no patient was intubated without undergoing CT of the cervical spine or head, seven patients had plain films when it was clear that they were to undergo CT. In conclusion, the audit emphasised the excellent work of emergency department and radiology staff in identifying and imaging multiple trauma patients, as all patients requiring CT of the cervical spine received this investigation. However, careful thought should be given to ordering plain films before CT, as some patients who clearly required CT of the cervical spine underwent unnecessary lateral plain films in the emergency department, delaying their progression to definitive care.

  16. Clinical applications of non-invasive imaging techniques in suspected coronary artery disease and in acute myocardial infarction

    NARCIS (Netherlands)

    Nucifora, Gaetano


    Non-invasive cardiac imaging modalities play a crucial role in the diagnostic process and clinical management of patients without known coronary artery disease and patients with acute myocardial infarction. The first part of the thesis discusses the use of non-invasive imaging modalities (including


    NARCIS (Netherlands)



    Magnetic resonance imaging (MRI) was performed on 66 cold-stored human donor livers. Spin echo images were obtained with a clinical whole body MRI system. Various parenchymal and vascular abnormalities were found. An unexpected finding was the abundant presence of intrahepatic air. Although the majo

  18. A review of treatment planning for precision image-guided photon beam pre-clinical animal radiation studies

    NARCIS (Netherlands)

    Verhaegen, Frank; van Hoof, Stefan; Granton, Patrick V; Trani, Daniela


    Recently, precision irradiators integrated with a high-resolution CT imaging device became available for pre-clinical studies. These research platforms offer significant advantages over older generations of animal irradiators in terms of precision and accuracy of image-guided radiation targeting. Th

  19. Diffusion weighted imaging of female pelvic cancers: Concepts and clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Punwani, Shonit, E-mail: [Department of Academic Radiology, 2nd Floor Podium, University College London Hospital, 235 Euston Road, London NW1 2BU (United Kingdom)


    Early applications of diffusion weighted magnetic resonance imaging (DWI) were limited to neuroimaging, concentrating either on stroke or brain tumours. With recent advances in MRI hardware and software DWI is now increasingly being investigated for cancer assessment throughout the body. Clinical applications of DWI relating to female pelvic cancers have largely concentrated on detection, localisation and staging of disease. More recently investigators have started to evaluate the ability of DWI for determining tumour histology and even predicting the outcome of chemoradiation treatment. This article reviews the physical concepts of MR diffusion weighting, illustrates the biophysical basis of diffusion contrast and reports the clinical applications of DWI for cervical, endometrial, ovarian, rectal and bladder tumours.

  20. Wernicke's encephalopathy in a malnourished surgical patient: clinical features and magnetic resonance imaging. (United States)

    Nolli, M; Barbieri, A; Pinna, C; Pasetto, A; Nicosia, F


    We report a clinical and neuroradiological description of a severe case of Wernicke's encephalopathy in a surgical patient. After colonic surgery for neoplasm, he was treated for a long time with high glucose concentration total parenteral nutrition. In the early post-operative period, the patient showed severe encephalopathy with ataxia, ophthalmoplegia and consciousness disorders. We used magnetic resonance imaging (MRI) to confirm the clinical suspicion of Wernicke's encephalopathy. The radiological feature showed hyperintense lesions which were symmetrically distributed along the bulbo-pontine tegmentum, the tectum of the mid-brain, the periacqueductal grey substance, the hypothalamus and the medial periventricular parts of the thalamus. This progressed to typical Wernicke-Korsakoff syndrome with ataxia and memory and cognitive defects. Thiamine deficiency is a re-emerging problem in non-alcoholic patients and it may develop in surgical patients with risk factors such as malnutrition, prolonged vomiting and long-term high glucose concentration parenteral nutrition.

  1. Appropriateness criteria for cardiovascular imaging use in clinical practice: a position statement of the ESC/EACVI taskforce.


    Garbi, Madalina; Habib, Gilbert; Plein, Sven; Neglia, Danilo; Kitsiou, Anastasia; Donal, Erwan; Pinto, Fausto; Bax, Jeroen; Achenbach, Stephan; Popescu, Bogdan A; Edvardsen, Thor; Badano, Luigi P.; Stefanidis, Alexandros; Bucciarelli-Ducci, Chiara; Derumeaux, Genevieve


    There is a growing interest from the scientific community in the appropriate use of cardiovascular imaging techniques for diagnosis and decision making in Europe. To develop appropriateness criteria for cardiovascular imaging use in clinical practice in Europe, a dedicated taskforce has been appointed by the European Society of Cardiology (ESC) and the European Association of Cardiovascular Imaging (EACVI). The present paper describes the appropriateness criteria development process. Peer ...

  2. Demonstration of the postcommissural fibres of the fornix in short-inversion time inversion-recovery imaging on a high-field system

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    Saeki, N.; Kansaku, K.; Higuchi, Y.; Yamaura, A. [Dept. of Neurological Surgery, Chiba University School of Medicine (Japan); Kawano, K.; Iijima, T. [Electrotechnical Lab., Tsukuba (Japan); Inoue, N. [GE Yokagawa Medical Systems, Tokyo (Japan)


    Short-inversion time inversion-recovery (STIR) imaging using a 3 tesla system was assessed to reveal the postcommissural fibres (PF) of the fornix, which have rarely been highlighted neuroradiologically in t