This study tested the hypothesis that shows advanced image analysis can differentiate fit and unfit patients for radical radiotherapy from standard radiotherapy planning imaging, when compared to ...formal lung function tests, FEV1 (forced expiratory volume in 1 s) and TLCO (transfer factor of carbon monoxide).
An apical region of interest (ROI) of lung parenchyma was extracted from a standard radiotherapy planning CT scan. Software using a grey level co-occurrence matrix (GLCM) assigned an entropy score to each voxel, based on its similarity to the voxels around it.
Density and entropy scores were compared between a cohort of 29 fit patients (defined as FEV1 and TLCO above 50 % predicted value) and 32 unfit patients (FEV1 or TLCO below 50% predicted). Mean and median density and median entropy were significantly different between fit and unfit patients (
= 0.005, 0.0008 and 0.0418 respectively; two-sided Mann-Whitney test).
Density and entropy assessment can differentiate between fit and unfit patients for radical radiotherapy, using standard CT imaging.
This study shows that a novel assessment can generate further data from standard CT imaging. These data could be combined with existing studies to form a multiorgan patient fitness assessment from a single CT scan.
The purpose of this study was to assess the utility of CT-based renal cortex volume to estimate split renal function (SRF) in pre-transplant living kidney donors and to evaluate its reliability to ...predict graft function in the recipients.
Our study recruited all adult potential donors who had both Tc-99m-diethylenetriamine pentacetate (DTPA) scintigraphy and CT angiography of the abdominal aorta done before donating their kidney. We compared the correlation between CT-based renal cortex volume combined with kidney function and DTPA scan as well as post-donation kidney function in the recipients.
The correlation between CT-based split cortex volume and DTPA-measured SRF before transplantation was strong (intraclass correlation coefficient = 0.954-0.968). The inter-rater reliability of two radiologists also showed substantial agreement (intraclass correlation coefficient = 0.97,
< 0.001). In contrast, the correlations between renal cortical volume of donated kidney adjusted to recipient body weight and recipient kidney function was poor at both 2 week and 2 year follow-up.
CT-based renal cortex volume combined with pre-operative kidney function appears to be precise and reproducible to evaluate pre-transplant SRF. Nevertheless, the prediction of recipient graft function needs to be further investigated to ensure a good outcome.
This method is practicable for all potential donors who undergo kidney transplantation in terms of streamline donor workup without compromising information.
To describe the challenges inherent in diagnosing fibrosing lung diseases (FLD) on CT imaging and methodologies by which the diagnostic process may be simplified.
Extensive searches in online ...scientific databases were performed to provide relevant and contemporary evidence that describe the current state of knowledge related to FLD diagnosis. This includes descriptions of the utility of a working diagnosis for an individual case discussed in a multidisciplinary team (MDT) setting and challenges associated with the lack of consensus guidelines for diagnosing chronic hypersensitivity pneumonitis.
As well as describing imaging features that indicate the presence of a fibrosing lung disease, those CT characteristics that nuance a diagnosis of the various FLDs are considered. The review also explains the essential information that a radiologist needs to convey to an MDT when reading a CT scan. Lastly, we provide some insights as to the future directions the field make take in the upcoming years.
This review outlines the current state of FLD diagnosis and emphasizes areas where knowledge is limited, and more evidence is required. Fundamentally, however, it provides a guide for radiologists when tackling CT imaging in a patient with FLD.
This review encompasses advice from recent guideline statements and evidence from the latest studies in FLD to provide an up-to-date manual for radiologists to aid the diagnosis of FLD on CT imaging in an MDT setting.
This prospective observational study of positron emission tomography (PET)-MRI findings in 16 consecutive newly diagnosed patients with a plasma cell dyscrasia describes and compares MRI-detected ...myeloma lesions with
F-fludeoxyglucose PET-avid myeloma lesions, and correlates quantitative imaging findings to a range of biochemical and prognostic parameters.
Simultaneously acquired whole body PET and MRI images were evaluated qualitatively for the presence of focal or generalised abnormalities of bone marrow (BM) on either modality. Quantitative analysis comprised mean standardised uptake values (SUVmean) and fractional water content of the BM measured from PET and chemical shift MRI images of the second to fourth lumbar vertebrae.
Final diagnoses comprised symptomatic myeloma (
= 10), asymptomatic myeloma (
= 4) and monoclonal gammopathy of uncertain significance (
= 2). 8/10 patients with symptomatic myeloma demonstrated BM abnormalities on qualitative assessment of MRI compared to 4/10 on PET. BM SUVmean inversely correlated with serum albumin (
= 0.57,
= 0.017). BM water fraction correlated with trephine cellularity and blood platelet count (
= 0.78,
= 0.00039 and
= 0.61,
= 0.0013 respectively). BM water fraction correlated with SUVmean in patients with low plasma cell burden (
= 0.91,
= 0.0015) but not in patients with high plasma cell burden (
= 0.18,
= 0.61).
PET-MRI shows promise in both morphological and functional multiparametric quantitative assessment of myeloma.
For the first time, multiparametric imaging in myeloma has been shown to predict BM abnormalities and correlate with known biochemical prognostic markers, moving PET-MRI beyond simple diagnostic applications into potential prognostic and treatment selection applications.
Breast cancer is a significant health concern in females, worldwide.
proton (
H) MR spectroscopy (MRS) has evolved as a non-invasive tool for diagnosis and for biochemical characterization of breast ...cancer. Water-to-fat ratio, fat and water fractions and choline containing compounds (tCho) have been identified as diagnostic biomarkers of malignancy. Detection of tCho in normal breast tissue of volunteers and in lactating females limits the use of tCho as a diagnostic marker. Technological developments like high-field scanners, multi channel coils, pulse sequences with water and fat suppression facilitated easy detection of tCho. Also, quantification of tCho and its cut-off for objective assessment of malignancy have been reported. Meta-analysis of
H MRS studies have documented the pooled sensitivities and the specificities in the range of 71-74% and 78-88%, respectively. Inclusion of MRS has been shown to enhance the diagnostic specificity of MRI, however, detection of tCho in small sized lesions (≤1 cm) is challenging even at high magnetic fields. Potential of MRS in monitoring the effect of chemotherapy in breast cancer has also been reported. This review briefly presents the potential clinical role of
H MRS in the diagnosis of breast cancer, its current status and future developments.
To investigate motion artifacts on kV CBCT and MV CBCT images with metal localization devices for image-guided radiation therapy.
The 8 μ pelvis CBCT template for the Siemens Artiste MVision and ...Pelvis template for the Varian IX on-board Exact Arms kV were used to acquire CBCT images in this study. Images from both CBCT modalities were compared in CNRs, metal landmark absolute positions, and image volume distortion on three different planes of view. The images were taken on a breathing-simulated thoracic phantom in which several typical metal localization devices were implanted, including clips and wires for breast patients, gold seeds for prostate patients, and BBs as skin markers. To magnify the artifacts, a 4 cm diameter metal ball was also implanted into the thoracic phantom to mimic the metal artifacts.
For MV CBCT, the CNR at a 4 sec breathing cycle with 1 cm breathing amplitude was 5.0, 3.4 and 4.6 for clips, gold seeds and BBs, respectively while it was 1.5, 2.0 and 1.6 for the kV CBCT. On the images, the kV CBCT showed symmetric streaking artifacts both in the transverse and longitudinal directions relative to the motion direction. The kV CBCT images predicted 89 % of the expected volume, while the MV CBCT images predicted 95 % of the expected volume. The simulated soft tissue observed in the MVCT could not be detected in the kV CBCT.
The MV CBCT images showed better volume prediction, less streaking effects and better CNRs of a moving metal target,
. clips, BBs, gold seeds and metal balls than on the kV CBCT images. The MV CBCT was more advantageous compared to the kV CBCT with less motion artifacts for metal localization devices.
This study would benefit clinicians to prescribe MV CBCT as localization modality for radiation treatment with moving target when metal markers are implanted.
In the following pictorial review, common and uncommon neurovascular complications associated with a spectrum of viral, bacterial and fungal infections involving the central nervous system will be ...illustrated. These complications include cerebral vascular insult, venous thrombosis, vasculitis and aneurysm formation. They can occur as separate entities but are often inter-related. The imaging features of neurovascular complication related to infections can provide clues and aid diagnosis when considering the potential mode of infectious spread and the type of potential infectious organism involved. The radiological appearances vary from common features that are shared by several types of pathogens to typical characteristics of a type of infectious organism.
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