ABSTRACT
The CT and MRI scans of a 70-year-old male patient revealed a mass in the pancreatic head and a 2.8-cm peripancreatic lymph node. Under steroid therapy the mass did not show regression. Finally, a pancreatoduodenectomy was performed. Histologically, Rosai-Dorfman disease (RDD) was diagnosed. RDD is a rare histiocytic disorder with usually nodal but sometimes also extranodal involvement. Herein we report a rare case of extranodal RDD with intrapancreatic localization.
Subject(s)
Histiocytosis, Sinus , Aged , Histiocytes , Histiocytosis, Sinus/diagnosis , Humans , Lymph Nodes , Magnetic Resonance Imaging , Male , Rare DiseasesABSTRACT
We extend an agent-based multiscale model of vascular tumour growth and angiogenesis to describe transarterial chemoembolisation (TACE) therapies. The model accounts for tumour and normal cells that are both nested in a vascular system that changes its structure according to tumour-related growth factors. Oxygen promotes nutrients to the tissue and determines cell proliferation or death rates. Within the extended model TACE is included as a two-step process: First, the purely mechanical influence of the embolisation therapy is modelled by a local occlusion of the tumour vasculature. There we distinguish between partial and complete responders, where parts of the vascular system are occluded for the first and the whole tumour vasculature is destroyed for the latter. In the second part of the model, drug eluding beads (DEBs) carrying the chemotherapeutic drug doxorubicin are located at destroyed vascular locations, releasing the drug over a certain time-window. Simulation results are parameterised to qualitatively reproduce clinical observations. Patients that undergo a TACE-treatment are categorised in partial and complete responders one day after the treatment. Another 90 days later reoccurance or complete response are detected by volume perfusion computer tomography (VPCT). Our simulations reveal that directly after a TACE- treatment an unstable tumour state can be observed, where regrowth and total tumour death have the same likeliness. It is argued that this short time-window is favorable for another therapeutical intervention with a less radical therapy. This procedure can shift the outcome to more effectiveness. Simulation results with an oxygen therapy within the unstable time-window demonstrate a potentially positive manipulated outcome. Finally, we conclude that our TACE model can motivate new therapeutical strategies and help clinicians analyse the intertwined relations and cross-links in tumours.
Subject(s)
Carcinoma, Hepatocellular/therapy , Chemoembolization, Therapeutic/methods , Carcinoma, Hepatocellular/pathology , Cone-Beam Computed Tomography/methods , Doxorubicin/administration & dosage , Humans , Liver Neoplasms/pathology , Liver Neoplasms/therapy , Models, Biological , Models, Theoretical , Tomography, X-Ray Computed/methods , Treatment OutcomeSubject(s)
Heart Atria , Mediastinal Diseases , Heart Atria/pathology , Humans , Mediastinal Diseases/diagnosisABSTRACT
OBJECTIVE: To test the hypothesis that both indolent and aggressive chronic lymphocytic leukemia (CLL) can be differentiated from diffuse large B cell lymphoma (DLBCL) of Richter syndrome (RS) by CT texture analysis (CTTA) of involved lymph nodes. MATERIAL AND METHODS: We retrospectively included 52 patients with indolent CLL (26/52), aggressive CLL (8/52), and DLBCL of RS (18/52), who underwent standardized contrast-enhanced CT. In main lymphoma tissue, VOIs were generated from which CTTA features including first-, second-, and higher-order textural features were extracted. CTTA features were compared between the entire CLL group, the indolent CLL subtype, the aggressive CLL subtype, and DLBCL using a Kruskal-Wallis test. All p values were adjusted after the Bonferroni correction. ROC analyses for significant CTTA features were performed to determine cut-off values for differentiation between the groups. RESULTS: Compared with DLBCL of RS, CTTA of the entire CLL group showed significant differences of entropy heterogeneity (p < 0.001), mean intensity (p < 0.001), mean average (p = 0.02), and number non-uniformity gray-level dependence matrix (NGLDM) (p = 0.03). Indolent CLL significantly differed for entropy (p < 0.001), uniformity of heterogeneity (p = 0.02), mean intensity (p < 0.001), and mean average (p = 0.01). Aggressive CLL showed significant differences in mean intensity (p = 0.04). For differentiation between CLL and DLBCL of RS, cut-off values for mean intensity and entropy of heterogeneity were defined (e.g., 6.63 for entropy heterogeneity [aggressive CLL vs. DLBCL]; sensitivity 0.78; specificity 0.63). CONCLUSIONS: CTTA features of ultrastructure and vascularization significantly differ in CLL compared with that in DLBCL of Richter syndrome, allowing complementary to visual features for noninvasive differentiation by contrast-enhanced CT. KEY POINTS: ⢠Richter transformation of CLL into DLBCL results in structural changes in lymph node architecture and vascularization that can be detected by CTTA. ⢠First-order CT textural features including intensity and heterogeneity significantly differ between both indolent CLL and aggressive CLL and DLBCL of Richter syndrome. ⢠CT texture analysis allows for noninvasive detection of Richter syndrome which is of prognostic value.
Subject(s)
Dendritic Cell Sarcoma, Follicular/pathology , Leukemia, Lymphocytic, Chronic, B-Cell/pathology , Lymphoma, Large B-Cell, Diffuse/pathology , Aged , Cell Differentiation , Dendritic Cell Sarcoma, Follicular/complications , Dendritic Cell Sarcoma, Follicular/diagnostic imaging , Female , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Leukemia, Lymphocytic, Chronic, B-Cell/diagnostic imaging , Lymph Nodes/pathology , Lymphoma, Large B-Cell, Diffuse/complications , Lymphoma, Large B-Cell, Diffuse/diagnostic imaging , Male , Middle Aged , Prognosis , Retrospective Studies , Sensitivity and Specificity , Syndrome , Tomography, X-Ray Computed/methodsABSTRACT
PURPOSE: To assess the effect of intraparenchymal blood patching (IBP) as well as tumor- and operator-related risk factors on the rate of pneumothoraxes after percutaneous CT-guided core needle biopsy of the lung. MATERIALS AND METHODS: We performed a retrospective analysis of 868 CT-guided lung biopsies that were conducted at our institution between 2003 and 2018, of which 419 (48%) received an IBP. Outcome variable included the rates of pneumothorax and chest tube placement, as well as lesion size (<3 cm versus ≥3 cm long axis diameter), lesion depth (≤2 cm, >2-4 cm, >4-5 cm and >5 cm distance to the pleura), location within the lungs (upper lobe, lower lobe, middle lobe), needle caliber (13 G, 15 G, 17 G, 19 G), number of samples taken (1-3 versus ≥4 samples), and experience of the performing physician. RESULTS: The rate of pneumothorax was significantly (p < 0.05) lower in the group with IBP (10.7%) compared to the group without IBP (15.4%). The number of post-interventional chest tube placements was also lower in the IBP group (3.1% vs. 5.8%) but not statistically significant. The lesion size correlated negatively with the rate of pneumothoraxes, whereas in both groups (±IBP) lesions ≥ 3 cm showed a significantly lower rate of pneumothorax (p < 0.05). With increasing lesion depth, the pneumothorax rate increased with (p < 0.01) and without (p < 0.001) IBP. The rate of pneumothorax was significantly lower (p < 0.05) for 17 G needles with IBP, but not for other calibers. For biopsies in the lower lobe, the pneumothorax rate reduced significantly (p < 0.001) with IBP. In case of ≥4 tissue samples, the pneumothorax rate was significantly lower with IBP (p < 0.01). For experienced operators, the overall pneumothorax rate was significantly lower compared to less experienced operators (p < 0001). CONCLUSIONS: IBP significantly reduces the rate of pneumothorax following CT-guided lung biopsies in particular for lesions located deeper in the lungs, when ≥4 samples are taken, when samples are taken by less-experienced operators, and when sampling from the lower lobes.
Subject(s)
Biological Therapy/methods , Lung/pathology , Pneumothorax/epidemiology , Pneumothorax/prevention & control , Radiography, Interventional/methods , Tomography, X-Ray Computed/methods , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy, Large-Core Needle/adverse effects , Chest Tubes/statistics & numerical data , Clinical Competence/statistics & numerical data , Female , Humans , Image-Guided Biopsy/adverse effects , Image-Guided Biopsy/methods , Lung/diagnostic imaging , Male , Middle Aged , Retrospective Studies , Risk Factors , Young AdultABSTRACT
PURPOSE: To compare the diagnostic performance of frequency-selective non-linear blending and conventional linear blending contrast-enhanced CT for the diagnosis of acute (AC) and gangrenous (GC) cholecystitis. MATERIALS AND METHODS: Following local ethics committee approval for retrospective data analysis, a database search derived 39 patients (26 men, mean age 67.8⯱â¯14.6 years) with clinical signs of acute cholecystitis, contrast enhanced CT (CECT) evaluation, cholecystectomy, and pathological examination of the resected specimen. The interval between CECT and surgery was 4.7⯱â¯4.1 days. Pathological gross examination was used to categorize the cases into AC and GC. Subsequently, two radiologists categorized the CECT studies in a blinded and independent fashion into AC and GC, during two different reading sessions using linear blending and frequency-selective non-linear blending CECT. RESULTS: Histologic analysis diagnosed 31/39 (79.4%) cases of GC and 8/39 (20.6%) cases of AC. Image interpretation of linear blending CECT resulted in classification of 7/39 (17.9%) patients as GC and 32/39 (82.1%) as AC, whereas image interpretation of frequency-selective non-linear blending CECT resulted in classification of 29/39 (74.3%) patients as GC and 10/39 (25.7%) as AC. Sensitivity/specificity/PPV/NPV for detection of GC were 22.6%/100%/100%/25% with linear blending CECT and 80.6%/50%/86.2%/40% with frequency-selective non-linear blending CECT, respectively. Based on the histopathologic diagnosis frequency-selective non-linear blending had a significant improvement (pâ¯>â¯0.0001) in the diagnostic accuracy of gangrenous cholecystitis compared with linear blending. CONCLUSION: Frequency-selective non-linear blending post-processing increases the diagnostic accuracy of gangrenous cholecystitis owing to improved visualization of absence of focal enhancement and mural ulcerations.
ABSTRACT
PURPOSE: To find CT-texture analysis (CTTA) features for the discrimination of splenomegaly due to diffuse lymphoma involvement and liver cirrhosis versus normal-sized spleens in controls and to assess their potential role for longitudinal lymphoma monitoring. MATERIAL AND METHODS: We had retrospectively identified 74 subjects with diffuse splenic involvement due to lymphoma (nâ¯=â¯29) and liver cirrhosis (nâ¯=â¯30), and healthy controls (nâ¯=â¯15), who underwent contrast-enhanced abdominal CT between August 2013 and October 2017. CTTA evaluation included heterogeneity, intensity, average, deviation, skewness, entropy of co-occurrence, number non-uniformity (NGLDM) and entropy NGLDM. A greater than 50% reduction of spleen volume after chemotherapy was considered proof for splenic involvement. RESULTS: There were significant differences of splenic CTTA-values before and after treatment of patients with lymphoma, including mean of entropy(pâ¯<â¯.001), uniformity of average(pâ¯<â¯.001), uniformity of deviation(pâ¯=â¯.002) and entropy of skewness(pâ¯<â¯.001). Significant differences of splenic CTTA-values in subjects with lymphoma vs. healthy controls were found for mean intensity(pâ¯<â¯.001), mean average(pâ¯<â¯.001), and entropy of deviation(pâ¯<â¯.001). No significant differences in splenic CTTA-values were found in subjects with lymphoma that reached complete remission vs. controls. Splenic CTTA values mean intensity(pâ¯=â¯.002) and mean average(pâ¯=â¯.004) were significantly different between subjects with untreated lymphoma and subjects with liver cirrhosis. At end-of-treatment all lymphomas reached complete remission. Entropy/uniformity of heterogeneity(pâ¯<â¯.001), mean intensity(pâ¯=â¯.007), mean average (pâ¯=â¯.007), uniformity of average(pâ¯=â¯.008) and mean/entropy/uniformity of skewness(pâ¯=â¯.001) measured at this time differed significantly from baseline. CONCLUSIONS: CTTA features in subjects with splenomegaly due to lymphoma and liver cirrhosis differ significantly from those of healthy controls and can be also used for monitoring lymphoma treatment. Quantitative CTTA features may increase the accuracy of diagnosing causes of splenomegaly.
Subject(s)
Liver Cirrhosis/diagnostic imaging , Liver Neoplasms/diagnostic imaging , Lymphoma/diagnostic imaging , Spleen/diagnostic imaging , Splenomegaly/diagnostic imaging , Tomography, X-Ray Computed , Adult , Aged , Aged, 80 and over , Female , Humans , Liver Cirrhosis/complications , Liver Cirrhosis/pathology , Liver Neoplasms/pathology , Lymphoma/pathology , Male , Middle Aged , Retrospective Studies , Spleen/pathology , Splenomegaly/etiology , Splenomegaly/pathology , Young AdultABSTRACT
PURPOSE: To evaluate the role of CT-textural features for monitoring lung involvement in subjects with systemic sclerosis(SSc) undergoing autologous stem cell transplantation(SCT) by comparison with semi-quantitative chest-CT, pulmonary function tests(PFT) and clinical parameters (modified Rodnan skin score[mRSS]). METHODS: In a retrospective single centre analysis, we identified 23 consecutive subjects(11male) with SSc between 07/2005 and 11/2016 that underwent chest CTs before, 6 and 12 months post-SCT. Response to therapy was defined at 6 months after transplantation as stabilisation or improvement in FVCâ¯>â¯10% and DLCOSBâ¯>â¯10%. CT-texture analysis(CTTA) including mean, entropy and uniformity were calculated. RESULTS: PFT classified the subjects into responders(18/23;78%) and non-responders(5/23;22%). mRSS improved in responders from 28.46⯱â¯9.53 to 15.70⯱â¯10.07 6 months after auto-SCT(pâ¯=â¯.001) whereas in non-responders no significant improvement was registered. Fibrosis score increased significantly(mean2.33⯱â¯1.23 vs.1.41⯱â¯0.78; pâ¯=â¯.005) in non-responders after 6 and 12months. Significant lower mean intensity and entropy of skewness and higher uniformity of skewness was found in responders vs. non-responders at baseline. Significant changes in CTTA-parameters were found in both responders and non-responders at 6months and only in responders also at 12months post-SCT. CONCLUSIONS: Changes in CT-textural features after SCT are associated with visual CT evaluation of SSc-related lung abnormalities, but complementary provide information about therapy-induced, structural pulmonary changes.
Subject(s)
Lung Diseases/diagnostic imaging , Scleroderma, Systemic/diagnostic imaging , Adult , Female , Hematopoietic Stem Cell Transplantation , Humans , Lung Diseases/pathology , Lung Diseases/physiopathology , Male , Middle Aged , Radiography, Thoracic/methods , Respiratory Function Tests , Retrospective Studies , Scleroderma, Systemic/pathology , Scleroderma, Systemic/physiopathology , Tomography, X-Ray ComputedABSTRACT
PURPOSE: To compare qualitative and quantitative computed tomography (CT) and magnetic resonance imaging (MRI) parameters for longitudinal disease monitoring of multiple myeloma (MM) of the axial skeleton. MATERIALS AND METHODS: We included 31 consecutive patients (17 m; mean age 59.20 ± 8.08 years) with MM, who underwent all baseline (n = 31) and at least one or more (n = 47) follow-up examinations consisting of multi-parametric non-enhanced whole-body MRI (WBMRI) and non-enhanced whole-body reduced-dose thin-section MDCT (NEWBMDCT) between 06/2013 and 09/2016. We classified response according to qualitative CT criteria into progression (PD), stable(SD), partial/very good partial (PR/VGPR) and complete response(CR), grouping the latter three together for statistical analysis because CT cannot reliably assess PR and CR. Qualitative MR-response criteria were defined and grouped similarly to CT using longitudinal quantification of signal-intensity changes on T1w/STIR/ T2*w and calculating ADC-values. Standard of reference was the hematological laboratory (M-gradient). RESULTS: Hematological response categories were CR (14/47, 29.7%), PR (2/47, 4.2%), SD (16/47, 34.0%) and PD (15/47, 29.9%). Qualitative-CT-evaluation showed PD in 12/47 (25.5%) and SD/PR/VGPR/CR in 35/47 (74.5%) cases. These results were confirmed by quantitative-CT in all focal lytic lesions (p < 0.001). Quantitative-CT at sites with diffuse bone involvement showed significant increase of maximum bone attenuation (p < 0.001*) and significant decrease of minimal bone (p < 0.002*) in the SD/PR/VGPR/CR group. Qualitative MRI showed PD in 14/47 (29.7%) and SD/PR/VGPR/CR in 33/47 (70.3%). Quantitative MRI diagnosis showed a statistically significant decrease in signal intensity on short tau inversion recovery sequences (STIR) in bone marrow in patients with diffuse bone marrow involvement achieving SD/PR/VGPR/CR (p < 0.001*). CONCLUSION: Imaging response monitoring using MRI is superior to CT only if qualitative parameters are used, whereas there was no definite benefit from using quantitative parameters with either CT or MRI.
Subject(s)
Magnetic Resonance Imaging/methods , Multiple Myeloma/diagnostic imaging , Spinal Neoplasms/diagnostic imaging , Tomography, X-Ray Computed/methods , Adult , Aged , Disease Progression , Female , Humans , Male , Middle Aged , Multiple Myeloma/therapy , Retrospective Studies , Spinal Neoplasms/therapy , Whole Body ImagingSubject(s)
Jaw Diseases/diagnosis , Jaw Neoplasms/diagnosis , Diagnosis, Differential , Diagnostic Imaging , Humans , Jaw Diseases/classification , Jaw Diseases/therapy , Jaw Neoplasms/classification , Jaw Neoplasms/secondary , Jaw Neoplasms/therapy , Odontogenic Cysts/classification , Odontogenic Cysts/diagnosis , Odontogenic Cysts/therapy , Odontogenic Tumors/classification , Odontogenic Tumors/diagnosis , Odontogenic Tumors/therapy , Osteomyelitis/classification , Osteomyelitis/diagnosis , Osteomyelitis/therapy , PrognosisABSTRACT
Purpose: To evaluate the effects of a new frequency selective non-linear blending (NLB) algorithm on the contrast resolution of liver CT with low intravascular concentration of iodine contrast. Materials and Methods: Our local ethics committee approved this retrospective study. The informed consent requirement was waived. CT exams of 25 patients (60â% female, mean age: 65â±â16 years of age) with late phase CT scans of the liver were included as a model for poor intrahepatic vascular contrast enhancement. Optimal post-processing settings to enhance the contrast of hepatic vessels were determined. Outcome variables included signal-to-noise (SNR) and contrast-to-noise ratios (CNR) of hepatic vessels and SNR of liver parenchyma of standard and post-processed images. Image quality was quantified by two independent readers using Likert scales. Results: The post-processing settings for the visualization of hepatic vasculature were optimal at a center of 115HU, delta of 25HU, and slope of 5. Image noise was statistically indifferent between standard and post-processed images. The CNR between the hepatic vasculature (HV) and liver parenchyma could be significantly increased for liver veins (CNRStandard 1.62â±â1.10, CNRNLB 3.6â±â2.94, pâ=â0.0002) and portal veins (CNRStandard 1.31â±â0.85, CNRNLB 2.42â±â3.03, pâ=â0.046). The SNR of liver parenchyma was significantly higher on post-processed images (SNRNLB 11.26â±â3.16, SNRStandard 8.85â± 2.27, pâ=â0.008). The overall image quality and depiction of HV were significantly higher on post-processed images (NLBDHV: 4 [3â-â4.75], StandardDHV: 2 [1.3â-â2.5], pâ=â<â0.0001; NLBIQ: 4 [4â-â4], StandardIQ: 2 [2â-â3], pâ=â<â0.0001). Conclusion: The use of a frequency selective non-linear blending algorithm increases the contrast resolution of liver CT and can improve the visibility of the hepatic vasculature in the setting of a low contrast ratio between vessels and the parenchyma. Key Points: â¢âUsing the new frequency selective non-linear blending algorithm is feasible in contrast-enhanced liver CT.â¢âOptimal post-processing settings make it possible to significantly increase the contrast resolution of liver CT without affecting image noise.â¢âEspecially in low contrast CT images, the novel algorithm is capable of significantly increasing image quality. Citation Format: â¢âBongers MN, Bier G, Kloth C etâal. Frequency Selective Non-Linear Blending to Improve Image Quality in Liver CT. Fortschr Röntgenstr 2016; 188: 1163â-â1168.
Subject(s)
Algorithms , Hepatic Artery/diagnostic imaging , Hepatic Veins/diagnostic imaging , Liver/diagnostic imaging , Radiographic Image Enhancement/methods , Tomography, X-Ray Computed/methods , Adult , Aged , Aged, 80 and over , Female , Humans , Liver/blood supply , Male , Middle Aged , Nonlinear Dynamics , Radiographic Image Interpretation, Computer-Assisted/methods , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
Purpose: The aim of the study was to evaluate safety, effectiveness, recurrence rate and 10-year survival after bronchial artery embolization (BAE) in benign and malignant etiologies. Methods: The retrospective study includes 100 BAE procedures in 88 patients. Underlying disease was classified as benign (nâ=â67) and malignant (nâ=â21) etiologies. Immediate bleeding control and procedure safety were evaluated in all patients. In 51 (58â%) patients, follow-up data with a median follow-up time of 1015 days (range, 494 to 3727 days) were acquired to assess overall survival, time-to-recurrence of bleeding and recurrence-free survival, using Kaplan-Maier estimates to compare differences between both subgroups. Results: Immediate bleeding control was achieved after 96/100 procedures (96â%), with a minor complication rate of 5.0â%. No major complications occurred. The overall survival was 74â% after 1 year and 59â% after 5 years and 10 years. There was a significant difference in survival between the malignant and benign groups (pâ<â0.0001). Survival was 90â%, 80â% and 76â% at 1 year, 3 years and 10 years, respectively, in the benign group and 18â% and 0â% at 1 year and 3 years, respectively in the malignant group.âThe median time to recurrence of bleeding and recurrence-free survival were 239 days and 94â% after 1 year and 87â% after 10 years in the benign group, compared to 66 days and 34â% after 1 year and 0â% after 3 years in the malignant group (pâ=â0.0107). Conclusion: BAE is a safe and highly effective treatment option in hemoptysis. However, the recurrence rate and survival are highly dependent on the underlying disease. Key Points: â¢âBAE is a safe and highly effective treatment option in hemoptysis.â¢âRecurrence rate and survival are strongly dependent on the underlying disease with significantly impaired results in patients with malignant diseases. â¢âCoil embolization is an effective BAE treatment method. Nevertheless, it should be mentioned, that reinterventions can be impeded, if embolization is performed in the proximal part of bronchial arteries. Citation Format: â¢âSyha R, Benz T, Hetzel J etâal. Bronchial Artery Embolization in Hemoptysis: 10-Year Survival and Recurrence-Free Survival in Benign and Malignant Etiologies - A Retrospective Study. Fortschr Röntgenstr 2016; 188: 1061â-â1066.
Subject(s)
Brachial Artery , Embolization, Therapeutic/mortality , Embolization, Therapeutic/methods , Hemoptysis/mortality , Hemoptysis/therapy , Lung Neoplasms/mortality , Adult , Aged , Disease-Free Survival , Germany/epidemiology , Hemostatics/therapeutic use , Humans , Longitudinal Studies , Lung Neoplasms/therapy , Middle Aged , Prevalence , Recurrence , Retrospective Studies , Risk Factors , Survival Rate , Treatment OutcomeABSTRACT
PURPOSE: To evaluate whether VEGFR-2-expression in hepatocellular carcinoma (HCC), dysplastic (DLN) and regenerative liver nodules (RLN) correlates with pre-histology, in vivo Dynamic Contrast Enhanced-Computed Tomography (DCE-CT) data as VEGFR-2-expression affects prognosis and therapeutic options. MATERIALS AND METHODS: 34 patients (63.6±8.9years, 7 females) underwent liver biopsy or surgery due to suspected HCC or dysplastic nodules after DCE-CT between 2009 and 2015 with no previous chemo- or interventional therapy. Immunohistochemistry staining for VEGFR-2 was performed using Immunoreactive-Remmele-Stegner-Score (IRS) for quantification. A 128-row CT-scanner was used for DCE-CT with assessment of perfusion parameters blood flow (BF), blood volume (BV), arterial liver perfusion (ALP), portal venous perfusion (PVP), and hepatic perfusion index (HPI). RESULTS: Histology confirmed HCC (n=10), DLN (n=7) and RLN (n=34). Mean IRS for VEGFR-2 in HCCs was 9.1±3.0, 7.3±1.6 for DLN and 5.2±2.8 for RLN (p=0.0004 for HCC vs. RLN). Perfusion values varied significantly between all three groups for BF and HPI (p<0.001 and p<0.0001) and for BV in HCC vs. RLN (p<0.0001) and DLN vs. RLN (p=0.0019). Strong correlations between VEGFR-2-IRS and perfusion parameters were observed for BF in HCC (r=0.88, p<0.01) and HPI in HCC and DLN (r=0.85, p<0.04; r=0.9, p<0.01). CONCLUSION: Immunostaining revealed different VEGFR-2-expression levels in HCC, dysplastic and regenerative liver nodules. Perfusion markers blood flow, blood volume and hepatic perfusion index correlated well with VEGFR-2-immunostaining. This non-invasive discrimination between regenerative and dysplastic/HCC nodules might open new perspectives for diagnosis, therapy planning, and anti-VEGFR therapy monitoring.
Subject(s)
Carcinoma, Hepatocellular/metabolism , Liver Neoplasms/metabolism , Liver Regeneration , Liver/diagnostic imaging , Liver/metabolism , Tomography, Spiral Computed/methods , Vascular Endothelial Growth Factor Receptor-2/metabolism , Aged , Biopsy , Blood Volume , Carcinoma, Hepatocellular/blood supply , Carcinoma, Hepatocellular/diagnostic imaging , Carcinoma, Hepatocellular/surgery , Female , Humans , Immunohistochemistry , Liver/pathology , Liver/surgery , Liver Neoplasms/blood supply , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/surgery , Male , Middle Aged , Perfusion Imaging , Prognosis , ROC Curve , Reproducibility of Results , Retrospective Studies , Sensitivity and SpecificitySubject(s)
Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Magnetic Resonance Imaging/methods , Neuroendocrine Tumors/diagnostic imaging , Neuroendocrine Tumors/pathology , Positron Emission Tomography Computed Tomography/methods , Adult , Aged , Diagnosis, Differential , Female , Humans , Image Enhancement/methods , Male , Middle AgedSubject(s)
Chemoradiotherapy/adverse effects , Gastrointestinal Diseases/diagnostic imaging , Gastrointestinal Diseases/etiology , Hematologic Neoplasms/complications , Hematologic Neoplasms/therapy , Radiation Injuries/diagnostic imaging , Diagnosis, Differential , Hematologic Neoplasms/diagnostic imaging , Humans , Magnetic Resonance Imaging/methods , Radiation Injuries/etiology , Tomography, X-Ray Computed/methodsSubject(s)
Heart Neoplasms/diagnostic imaging , Sarcoma, Myeloid/diagnostic imaging , Adult , Aged , Child , Cross-Sectional Studies , Diagnosis, Differential , Echocardiography , Female , Heart Neoplasms/epidemiology , Heart Neoplasms/therapy , Humans , Leukemia, Myeloid, Acute/diagnostic imaging , Leukemia, Myeloid, Acute/therapy , Magnetic Resonance Imaging , Male , Middle Aged , Myocardial Perfusion Imaging , Neoplasm Recurrence, Local/diagnostic imaging , Neoplasm Recurrence, Local/therapy , Neoplasms, Multiple Primary/diagnostic imaging , Neoplasms, Multiple Primary/therapy , Prognosis , Sarcoma, Myeloid/epidemiology , Sarcoma, Myeloid/therapy , Stem Cell Transplantation , Tomography, X-Ray ComputedABSTRACT
OBJECTIVES: To assess the impact of endobronchial coiling on the segment bronchus cross-sectional area and volumes in patients with lung emphysema using quantitative chest-CT measurements. MATERIALS AND METHODS: Thirty patients (female = 15; median age = 65.36 years) received chest-CT before and after endobronchial coiling for lung volume reduction (LVR) between January 2010 and December 2014. Thin-slice (0.6 mm) non-enhanced image data sets were acquired both at end-inspiration and end-expiration using helical technique and 120 kV/100-150 mAs. Clinical response was defined as an increase in the walking distance (Six-minute walk test; 6MWT) after LVR-therapy. Additionally, pulmonary function test (PFT) measurements were used for clinical correlation. RESULTS: In the treated segmental bronchia, the cross-sectional lumen area showed significant reduction (p < 0.05) in inspiration and tendency towards enlargement in expiration (p > 0.05). In the ipsilateral lobes, the lumina showed no significant changes. In the contralateral lung, we found tendency towards increased cross-sectional area in inspiration (p = 0.06). Volumes of the treated segments correlated with the treated segmental bronchial lumina in expiration (r = 0.80, p < 0.001). Clinical correlation with changes in 6MWT/PFT showed a significant decrease of the inspiratory volume of the treated lobe in responders only. CONCLUSION: Endobronchial coiling causes significant decrease in the cross-sectional area of treated segment bronchi in inspiration and a slight increase in expiration accompanied by a volume reduction. KEY POINTS: ⢠Endobronchial coiling has indirect impact on cross-sectional area of treated segment bronchi ⢠Volume changes of treated lobes correlate with changes in bronchial cross-sectional area ⢠Coil-induced effects reflect their stabilizing and stiffening impact on lung parenchyma ⢠Endobronchial coiling reduces bronchial collapsing compensating the loss of elasticity.