Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 14.360
Filtrar
1.
Medicine (Baltimore) ; 100(14): e25378, 2021 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-33832124

RESUMEN

INTRODUCTION: Multimodality assessment of coronary artery lesions has demonstrated superior effectiveness compared to the conventional approach, for assessing both anatomical and functional significance of a coronary stenosis. Multiple imaging modalities can be integrated into a fusion imaging tool to better assess myocardial ischemia. MATERIAL AND METHODS: The FUSE-HEART trial is a single center, prospective, cohort study that will assess the impact of a coronary artery stenosis on myocardial function and viability, based on advanced fusion imaging technics derived from Cardiac Computed Tomography Angiography (CCTA). Moreover, the study will investigate the correlation between morphology and composition of the coronary plaques and myocardial ischemia in the territory irrigated by the same coronary artery. At the same time, imaging parameters will be correlated with inflammatory status of the subjects. The trial will include 100 subjects with coronary lesions found on CCTA examination. The study population will be divided into 2 groups: first group will consist of subjects with anatomically significant coronary lesions on native coronary arteries and the second one will include subjects surviving an acute myocardial infarction. The vulnerability score of the subjects will be calculated based on presence of CCTA vulnerability markers of the coronary plaques: napkin ring sign, positive remodeling, spotty calcifications, necrotic core, and low-density plaques. 3D fusion images of the coronary tree will be generated, integrating the images reflecting wall motion with the ones of coronary circulation. The fusion models will establish the correspondence between plaque composition and wall motion in the subtended myocardium of the coronary artery. The study primary outcome will be represented by the rate of major adverse cardiac events related to myocardial ischemia at 1-year post assessment, in correlation with the degree of coronary artery stenosis and myocardial ischemia or viability.The secondary outcomes are represented by the rate of re-hospitalization, rate of survival and rate of major adverse cardiovascular events (including cardiovascular death or stroke), in correlation with the morphology and composition of atheromatous plaques located in a coronary artery, and myocardial ischemia in the territory irrigated by the same coronary artery. CONCLUSION: In conclusion, FUSE-HEART will be a study based on modern imaging tools that will investigate the impact of a coronary artery stenosis on myocardial function and viability, using advanced fusion imaging technics derived from CCTA, sighting to validate plaque composition and morphology, together with inflammatory biomarkers, as predictors to myocardial viability.


Asunto(s)
Vasos Coronarios/diagnóstico por imagen , Imagen Multimodal/métodos , Isquemia Miocárdica/complicaciones , Imagen de Perfusión Miocárdica/métodos , Estudios de Cohortes , Angiografía por Tomografía Computarizada/métodos , Estenosis Coronaria/complicaciones , Estenosis Coronaria/diagnóstico por imagen , Estenosis Coronaria/fisiopatología , Vasos Coronarios/patología , Humanos , Mediadores de Inflamación/metabolismo , Ensayos Clínicos Controlados no Aleatorios como Asunto , Evaluación de Resultado en la Atención de Salud , Placa Aterosclerótica/diagnóstico por imagen , Placa Aterosclerótica/fisiopatología , Estudios Prospectivos
2.
Adv Exp Med Biol ; 1256: 33-66, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33847997

RESUMEN

Age-related macular degeneration (AMD) is a progressive neuro-retinal disease and the leading cause of central vision loss among elderly individuals in the developed countries. Modern ocular imaging technologies constitute an essential component of the evaluation of these patients and have contributed extensively to our understanding of the disease. A challenge with any review of ocular imaging technologies is the rapid pace of progress and evolution of these instruments. Nonetheless, for proper and optimal use of these technologies, it is essential for the user to understand the technical principles underlying the imaging modality and their role in assessing the disease in various settings. Indeed, AMD, like many other retinal diseases, benefits from a multimodal imaging approach to optimally characterize the disease. In this chapter, we will review the various imaging technologies currently used in the assessment and management of AMD.


Asunto(s)
Degeneración Macular , Tomografía de Coherencia Óptica , Anciano , Angiografía con Fluoresceína , Humanos , Degeneración Macular/diagnóstico por imagen , Degeneración Macular/terapia , Imagen Multimodal , Retina/diagnóstico por imagen
3.
Medicine (Baltimore) ; 100(16): e25517, 2021 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-33879689

RESUMEN

RATIONALE: Primary schwannoma of the thyroid gland is very rare, and its preoperative diagnosis is difficult. PATIENT CONCERNS: We report the case of a thyroid nodule in an 18-year-old woman, who presented with a mass in her left neck with stiffness and normal thyroid function. However, the patient complained of numbness in her left upper extremity, and ultrasound (US) features were suspicious of malignancy. DIAGNOSES: Multimodal US imaging was performed using B-mode, color doppler, ultrasonic elastography (UE), and contrast-enhanced ultrasound (CEUS). CEUS revealed heterogeneous enhancement and "target sign" within the tumor. The nodule was suspicious for malignancy and classified as TI-RADS 4b, while the elasticity values measured by UE indicated a benign lesion. Fine needle aspiration (FNA) was subsequently performed in the markedly contrast-enhanced area for biopsy. Cytological results revealed a benign schwannoma. INTERVENTION: The patient underwent left lobe resection. Postoperative pathology confirmed it to be a primary benign schwannoma of the thyroid. OUTCOMES: After thyroidectomy, the patient was followed-up with US. At present, all laboratory tests and thyroid imaging are normal, and the numbness of the left upper limb has disappeared. LESSONS: The combination of different US modalities is useful for the diagnosis of thyroid lesions. FNA performed under CEUS guidance improves the accuracy of biopsy sampling.


Asunto(s)
Diagnóstico por Imagen de Elasticidad/métodos , Neurilemoma/diagnóstico , Glándula Tiroides/diagnóstico por imagen , Neoplasias de la Tiroides/diagnóstico , Ultrasonografía Doppler en Color/métodos , Adolescente , Biopsia con Aguja Fina , Medios de Contraste/administración & dosificación , Femenino , Humanos , Imagen Multimodal/métodos , Neurilemoma/patología , Neurilemoma/cirugía , Glándula Tiroides/patología , Glándula Tiroides/cirugía , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/cirugía , Tiroidectomía , Resultado del Tratamiento
4.
Artículo en Inglés | MEDLINE | ID: mdl-33810247

RESUMEN

Susac syndrome (SS) is a rare microangiopathy that involves arterioles of the brain, retina, and cochlea. Diagnosis is extremely difficult because of the rarity of the disease and because the signs and symptoms often occur at different times. Multidisciplinary approaches and multimodal images are mandatory for diagnosis and prompt therapy. In this report, we describe a case of SS and the application of multimodal retinal imaging to evaluate the ophthalmologic changes and to confirm diagnosis. Early diagnosis and therapy based on the associations of steroids and immunosuppressants are necessary to limit the sequelae of the disease.


Asunto(s)
Oclusión de la Arteria Retiniana , Síndrome de Susac , Encéfalo/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Imagen Multimodal , Síndrome de Susac/diagnóstico por imagen
5.
Curr Cardiol Rep ; 23(5): 44, 2021 03 15.
Artículo en Inglés | MEDLINE | ID: mdl-33721125

RESUMEN

PURPOSE OF REVIEW: A growing number of cardiovascular manifestations resulting from the novel SARS-CoV-2 coronavirus (COVID-19) have been described since the beginning of this global pandemic. Acute myocardial injury is common in this population and is associated with higher rates of morbidity and mortality. The focus of this review centers on the recent applications of multimodality imaging in the diagnosis and management of COVID-19-related cardiovascular conditions. RECENT FINDINGS: In addition to standard cardiac imaging techniques such as transthoracic echocardiography, other modalities including computed tomography and cardiac magnetic resonance imaging have emerged as useful adjuncts in select patients with COVID-19 infection, particularly those with suspected ischemic and nonischemic myocardial injury. Data have also emerged suggesting lasting COVID-19 subclinical cardiac effects, which may have long-term prognostic implications. With the spectrum of COVID-19 cardiovascular manifestations observed thus far, it is important for clinicians to recognize the role, strengths, and limitations of multimodality imaging techniques in this patient population.


Asunto(s)
Corazón , Humanos , Imagen Multimodal , Pandemias
6.
Lancet Oncol ; 22(3): 341-350, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33662286

RESUMEN

BACKGROUND: In addition to increased availability of treatment modalities, advanced imaging modalities are increasingly recommended to improve global cancer care. However, estimates of the costs and benefits of investments to improve cancer survival are scarce, especially for low-income and middle-income countries (LMICs). In this analysis, we aimed to estimate the costs and lifetime health and economic benefits of scaling up imaging and treatment modality packages on cancer survival, both globally and by country income group. METHODS: Using a previously developed model of global cancer survival, we estimated stage-specific cancer survival and life-years gained (accounting for competing mortality) in 200 countries and territories for patients diagnosed with one of 11 cancers (oesophagus, stomach, colon, rectum, anus, liver, pancreas, lung, breast, cervix uteri, and prostate) representing 60% of all cancer diagnoses between 2020 and 2030 (inclusive of full years). We evaluated the costs and health and economic benefits of scaling up packages of treatment (chemotherapy, surgery, radiotherapy, and targeted therapy), imaging modalities (ultrasound, x-ray, CT, MRI, PET, single-photon emission CT), and quality of care to the mean level of high-income countries, separately and in combination, compared with no scale-up. Costs and benefits are presented in 2018 US$ and discounted at 3% annually. FINDINGS: For the 11 cancers studied, we estimated that without scale-up (ie, with current availability of treatment, imaging, and quality of care) there will be 76·0 million cancer deaths (95% UI 73·9-78·6) globally for patients diagnosed between 2020 and 2030, with more than 70% of these deaths occurring in LMICs. Comprehensive scale-up of treatment, imaging, and quality of care could avert 12·5% (95% UI 9·0-16·3) of these deaths globally, ranging from 2·8% (1·8-4·3) in high-income countries to 38·2% (32·6-44·5) in low-income countries. Globally, we estimate that comprehensive scale-up would cost an additional $232·9 billion (95% UI 85·9-422·0) between 2020 and 2030 (representing a 6·9% increase in cancer treatment costs), but produce $2·9 trillion (1·8-4·0) in lifetime economic benefits, yielding a return of $12·43 (6·47-33·23) per dollar invested. Scaling up treatment and quality of care without imaging would yield a return of $6·15 (2·66-16·71) per dollar invested and avert 7·0% (3·9-10·3) of cancer deaths worldwide. INTERPRETATION: Simultaneous investment in cancer treatment, imaging, and quality of care could yield substantial health and economic benefits, especially in LMICs. These results provide a compelling rationale for the value of investing in the global scale-up of cancer care. FUNDING: Harvard TH Chan School of Public Health and National Cancer Institute.


Asunto(s)
Simulación por Computador , Prestación de Atención de Salud , Salud Global , Costos de la Atención en Salud/tendencias , Servicios de Salud/estadística & datos numéricos , Imagen Multimodal/métodos , Neoplasias/mortalidad , Adolescente , Adulto , Anciano , Terapia Combinada , Países en Desarrollo , Femenino , Estudios de Seguimiento , Humanos , Renta , Masculino , Persona de Mediana Edad , Neoplasias/economía , Neoplasias/patología , Neoplasias/terapia , Pronóstico , Tasa de Supervivencia , Adulto Joven
7.
Medicine (Baltimore) ; 100(9): e24706, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655935

RESUMEN

RATIONALE: A few cases of optic neuropathy presumed to be caused by vincristine have been reported. However, none described multimodal imaging findings. Here, we report abnormal magnetic resonance imaging (MRI) and optical coherence tomography (OCT) findings in a putative case of vincristine-induced optic neuropathy. PATIENT CONCERNS: A 9-year-old boy with Burkett lymphoma who had had no visual problems noticed blurred vision in both eyes 22 days after the first maintenance therapy for lymphoma; the blurred gradually worsened. At that time, the best-corrected visual acuity was 20/200 and 20/100 in the right and left eyes, respectively. DIAGNOSES: Blood and imaging workup, and cerebrospinal fluid and genetic analyses, were performed; these included fundus photography, OCT, and MRI. We found no plausible cause of the optic neuropathy other than vincristine. INTERVENTIONS: The scheduled chemotherapy was stopped, and the patient was managed with high-dose corticosteroids. However, as there was no improvement, plasma exchange was then performed. OUTCOMES: Three days after the initial examination, the visual acuity in both eyes was only light perception and projection. Signal intensity was abnormally high on 3-dimensional T2-weighted turbo spin echo and T2-weighted MRI images. Optic disc atrophy progressed to "total pallor"; thinning of the ganglion cell-inner plexiform and retinal nerve fiber layers also progressed. The patient was followed up for 7 months but showed no improvement in vision. There were no treatment-related complications. LESSONS: We conclude that vincristine can cause optic neuropathy, and clinicians need to be alert to the possibility of optic neuropathy in any patient prescribed this agent.OCT and MRI may help to diagnose optic neuropathy in pediatric patients. Periodic ophthalmologic examinations, including an OCT scan, may be useful.


Asunto(s)
Antineoplásicos Fitogénicos/efectos adversos , Imagen por Resonancia Magnética , Enfermedades del Nervio Óptico/diagnóstico por imagen , Tomografía de Coherencia Óptica , Vincristina/efectos adversos , Niño , Humanos , Linfoma/tratamiento farmacológico , Masculino , Imagen Multimodal , Enfermedades del Nervio Óptico/inducido químicamente
8.
Medicine (Baltimore) ; 100(7): e24728, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33607816

RESUMEN

INTRODUCTION: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a simple, reliable, minimally invasive and effective procedure. However, a surgical technique may be required, if the results are negative. Therefore, there is a need for new studies to increase the diagnostic value of EBUS-TBNA and provide additional information to guide the biopsy in performing the procedure. Here, we aimed to investigate the diagnostic value of EBUS-TBNA and 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in diagnosis of hilar and/or mediastinal lymph nodes (LNs). It was also aimed to determine the contributions of real-time ultrasonography (USG) images of LNs to distinguishing between the malignant and benign LNs during EBUS-TBNA, and in the diagnosis of anthracotic LNs. MATERIAL AND METHOD: In the retrospective study including 545 patients, 1068 LNs were sampled by EBUS-TBNA between January 2015 and February 2020. EBUS-TBNA, 18-FDG PET/CT and images of USG were investigated in the diagnosis of mediastinal and/or hilar malignant, anthracotic and other benign LNs. RESULTS: The sensitivity, specificity, positive predictive value and negative predictive value of EBUS-TBNA were found as 79.5, 98.1, 89.5, and 91.7%, respectively. Mean maximum standardized uptake value (SUVmax) values of 18F-FDG PET/CT were 6.31±4.3 in anthracotic LNs and 5.07 ±â€Š2.53 in reactive LNs. Also, mean SUVmax of malignant LNs was 11.02 ±â€Š7.30 and significantly higher than that of benign LNs. In differentiation of malignant-benign tumors, considering the cut off value of 18F-FDG PET/CT SUVmax as 2.72, the sensitivity and specificity was 99.3 and 11.7%, but given the cut off value as 6.48, the sensitivity, specificity, positive predictive value and negative predictive value was found as 76.5, 64, 20.49, and 78.38% for benign LNs, respectively. Compared LNs as to internal structure and contour features, malignant LNs had most often irregular contours and heterogeneous density. Anthracotic, reactive and other benign LNs were most frequently observed as regular contours and homogeneous density. The difference between malignant and benign LNs was significant. CONCLUSION: EBUS can contribute to the differential diagnosis of malignant, anthracotic and other benign LNs. Such contributions can guide clinician bronchoscopists during EBUS-TBNA. The triple modality of EBUS-TBNA, 18FDG PET/CT, and USG may increase the diagnostic value in hilar and mediastinal lymphadenopathies.


Asunto(s)
Antracosis/diagnóstico por imagen , Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico/métodos , Mediastino/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Ultrasonografía/métodos , Anciano , Antracosis/patología , Diagnóstico Diferencial , Femenino , Fluorodesoxiglucosa F18/metabolismo , Humanos , Ganglios Linfáticos/diagnóstico por imagen , Linfadenopatía/patología , Masculino , Mediastino/patología , Persona de Mediana Edad , Imagen Multimodal/métodos , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Sensibilidad y Especificidad
9.
Eur J Radiol ; 137: 109588, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33639542

RESUMEN

OBJECTIVES: To investigate a correlation between 68Ga-DOTATOC PET/MR imaging parameters such as arterial and venous contrast enhancement, diffusion restriction, and maximum standardized uptake value (SUVmax) with histopathological tumor grading in patients with neuroendocrine neoplasms (NEN). MATERIAL AND METHODS: A total of 26 patients with newly diagnosed, therapy-naive neuroendocrine neoplasms (NEN) were enrolled in this prospective study and underwent 68Ga-DOTATOC PET/MRI. Images were evaluated regarding NEN lesion number and location, predominant tumor signal intensity on precontrast T1w and T2w images and on postcontrast arterial and portal venous phase T1w images, apparent diffusion coefficient (ADC) and SUVmax. Histopathological tumor grading was assessed and related to PET/MRI features using Pearson's correlation coefficient and Fisher's exact t-test. A binary logistic regression analysis was performed to evaluate a potential relation with an aggressive tumor biology and odds ratios (OR) were calculated. RESULTS: There was a moderate negative correlation between arterial contrast enhancement and tumor grading (r=-0.35, p = 0.005), while portal venous enhancement showed a weak positive correlation with the Ki-67 index (r = 0.28, p = 0.008) and a non-significant positive correlation with tumor grading (r = 0.19, p = 0.063). Features that were significantly associated with an aggressive tumor biology were the presence of liver metastases (OR 2.6, p = 0.042), T1w hyperintensity in comparison to muscle (OR 12.7, p = 0.0001), arterial phase hyperenhancement (OR 1.4, p = 0.001), diffusion restriction (OR 2.8, p = 0.02) and SUVmax above the hepatic level (OR 7.0, p = 0.001). CONCLUSION: The study reveals that PET/MRI features might be useful for prediction of NEN grading and thus provide a preliminary assessment of tumor aggressiveness.


Asunto(s)
Radioisótopos de Galio , Neoplasias , Fluorodesoxiglucosa F18 , Humanos , Imagen por Resonancia Magnética , Imagen Multimodal , Clasificación del Tumor , Octreótido/análogos & derivados , Tomografía de Emisión de Positrones , Estudios Prospectivos , Radiofármacos
10.
Clin Imaging ; 74: 156-162, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33607596

RESUMEN

This pictorial essay is a presentation of imaging appearances of non-mammary cancer metastases to the breast detected in asymptomatic women attending BreastScreen Western Australia (BSWA) from 2005 to 2019. Haematological malignancies were excluded. Thirteen cases of histologically proven extramammary metastases to breast were identified from the BSWA data base. Five cases were ovarian cancer metastases, 3 melanoma metastases, 2 of adenocarcinoma metastases with foregut primary and one each of endometrial, renal and carcinoid metastases. Metastasis to breast commonly presented as circumscribed masses (N = 12) at mammography and as hypoechoic masses (N = 10) at ultrasound with a predilection to upper outer quadrant of breast. Metastases to breast from non-mammary primary while a rare occurrence in a breast screening program, may be the first clinical presentation of malignancy in asymptomatic women.


Asunto(s)
Neoplasias de la Mama , Radiología , Mama/diagnóstico por imagen , Neoplasias de la Mama/diagnóstico por imagen , Femenino , Humanos , Mamografía , Imagen Multimodal
11.
Medicine (Baltimore) ; 100(3): e24034, 2021 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-33546001

RESUMEN

RATIONALE: Fetal congenital mesoblastic nephroma (CMN) is a rare renal tumor, characterized by polyhydramnios, premature birth, and neonatal hypertension. In the prenatal stage, it is particularly difficult to diagnose CMN either by ultrasonography or magnetic resonance imaging (MRI). Thus, CMN is frequently detected in the third trimester in the clinical scenario. PATIENT CONCERNS: A 29-year-old G2P0 pregnant woman took routine prenatal examinations in our hospital. The fetal right kidney abnormality was not observed after 2 systematical ultrasonic examinations (at 24 and 31 weeks of gestation respectively), and only an increase was noticed in the amniotic fluid index (from 19.3 to 20.8 cm). DIAGNOSIS: CMN was detected by antenatal ultrasonography and MRI as a fetal right renal mass at 35 weeks of gestation in our hospital. INTERVENTIONS: The pregnant woman was admitted at a gestational age of 38 weeks and 5 days due to alterations in renal function. Further, the pregnant woman was administered with "oxytocin" to promote delivery, and the neonate underwent a right nephrectomy on the 9th day after birth. OUTCOMES: The pathological examination confirmed a cellular type of right CMN. The neonate recovered well after operation without adjuvant treatment. During 6 months of follow-up, the neonate grew well and showed no signs of recurrence or metastasis. CONCLUSION: Polyhydramnios detected during prenatal examination required attention due to the risk of malformation of fetal urinary system. Prenatal ultrasonography combined with MRI could not only clearly identify the origin of the tumor, but also distinguish the correlation between the tumor and adjacent structures, thereby leading to early diagnosis and favorable prognosis.


Asunto(s)
Feto/diagnóstico por imagen , Neoplasias Renales/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Nefroma Mesoblástico/diagnóstico por imagen , Ultrasonografía Prenatal/métodos , Adulto , Femenino , Edad Gestacional , Humanos , Recién Nacido , Neoplasias Renales/embriología , Neoplasias Renales/cirugía , Imagen Multimodal , Nefrectomía , Nefroma Mesoblástico/embriología , Nefroma Mesoblástico/cirugía , Embarazo
12.
BMJ Case Rep ; 14(2)2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33526522

RESUMEN

A 44-year-old woman presented with decreased vision in both eyes. The retina in both eyes had drusen distributed along vascular arcades, central macula and in peripapillary region. Macula had pigmented scarring and exudation. Fundus autofluorescence showed drusen. Optical coherence tomography showed drusen, subretinal and intraretinal fluid. Fundus fluorescein and indocyanine green angiography showed drusen, retinal pigment epithelial atrophy and vascular network. Younger age at presentation, bilateral symmetry, typical distribution of drusen along the arcades in a radiating pattern, peripapillary involvement, scarring and atrophy at macula were suggestive of doyne honeycomb retinal dystrophy. The reduced vision was due to macular atrophy and an active choroidal neovascular membrane. The patient was treated with antivascular endothelial growth factor injections for choroidal neovascular membrane. Our case highlights the importance of pattern recognition and multimodal imaging for diagnosing the type of macular dystrophy as doyne honeycomb retinal dystrophy, while simultaneously managing choroidal neovascular membrane.


Asunto(s)
Neovascularización Coroidal/diagnóstico por imagen , Angiografía con Fluoresceína , Tomografía de Coherencia Óptica , Adulto , Inhibidores de la Angiogénesis/uso terapéutico , Angiografía , Neovascularización Coroidal/complicaciones , Neovascularización Coroidal/tratamiento farmacológico , Colorantes , Femenino , Fondo de Ojo , Humanos , Verde de Indocianina , Inyecciones Intravítreas , Imagen Multimodal , Drusas del Disco Óptico/complicaciones , Drusas del Disco Óptico/congénito , Drusas del Disco Óptico/diagnóstico por imagen , Ranibizumab/uso terapéutico
13.
BMC Surg ; 21(1): 92, 2021 Feb 18.
Artículo en Inglés | MEDLINE | ID: mdl-33602167

RESUMEN

BACKGROUND: Orbital solitary fibrous tumors (SFTs) are rare neoplasms. Recurrent, hypervascular, malignant variations of orbital SFTs have recently been noted and can present a surgical challenge. CASE PRESENTATION: We describe a case of a 53-year-old Chinese woman with a history of a resected orbital SFT. She presented with proptosis, limited eyeball movement, and visual loss in the right eye, suggestive of a recurrent SFT. Ocular examination with multimodal imaging revealed a large, nonpulsatile, noncompressible, hypervascular mass behind the eyeball. The patient underwent preoperative transarterial embolization of the main blood supply to the tumor in order to control intraoperative blood loss, followed by ocular enucleation to optimize exposure and enable complete resection of the tumor. Embolization of the right ophthalmic artery and the distal branch of the right internal maxillary artery caused an immediate, substantial reduction of vascular flow, which allowed us to enucleate the eyeball and resect the tumor with minimal blood loss and no complications. CONCLUSIONS: Our case is so far the first Chinese case of successful preoperative embolization of the main blood supply to a large, recurrent, hypervascular orbital SFT. This case also described a different surgical approach to achieve total removal of an orbital SFT without osteotomy.


Asunto(s)
Embolización Terapéutica , Recurrencia Local de Neoplasia , Neoplasias Orbitales , Cuidados Preoperatorios , Tumores Fibrosos Solitarios , Grupo de Ascendencia Continental Asiática , Femenino , Humanos , Persona de Mediana Edad , Imagen Multimodal , Recurrencia Local de Neoplasia/irrigación sanguínea , Recurrencia Local de Neoplasia/diagnóstico por imagen , Recurrencia Local de Neoplasia/terapia , Neoplasias Orbitales/irrigación sanguínea , Neoplasias Orbitales/diagnóstico por imagen , Neoplasias Orbitales/terapia , Tumores Fibrosos Solitarios/irrigación sanguínea , Tumores Fibrosos Solitarios/diagnóstico por imagen , Tumores Fibrosos Solitarios/terapia , Resultado del Tratamiento
14.
Anticancer Res ; 41(1): 497-502, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33419848

RESUMEN

BACKGROUND/AIM: The role of neoadjuvant chemotherapy (NACT) is under investigation in locally advanced cervical cancer (LACC). PATIENTS AND METHODS: A total of 49 patients with FIGO stage IB1-IIB cervical cancer who underwent two different regimens of weekly dose-dense NACT were included. The objective was to evaluate clinical/pathological response and toxicity profile. RESULTS: A clinical complete response and partial response were obtained in 43 patients with a clinical overall response rate of 88%. Among the 42 surgically treated patients, 7 (17%) and 35 (83%) achieved a pathological overall optimal response and a suboptimal pathological response, respectively. G3-G4 neutropenia occurred in 16% of patients, whereas no cases of G3 thrombocytopenia, G3 anemia and febrile neutropenia were observed. CONCLUSION: Dose-dense NACT is safe, has acceptable toxicity, and obtains good clinical response, but is less effective in terms of pathological overall optimal response rates compared to other regimens.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias del Cuello Uterino/tratamiento farmacológico , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Carboplatino/administración & dosificación , Femenino , Humanos , Persona de Mediana Edad , Imagen Multimodal , Terapia Neoadyuvante , Estadificación de Neoplasias , Paclitaxel/administración & dosificación , Resultado del Tratamiento , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/mortalidad
15.
Cancer Imaging ; 21(1): 5, 2021 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-33413685

RESUMEN

BACKGROUND: We prospectively evaluated the diagnostic utility of whole-body diffusion-weighted imaging with background body signal suppression and T2-weighted short-tau inversion recovery MRI (WB-DWIBS/STIR) for the pretherapeutic staging of indolent lymphoma in 30 patients. METHODS: This prospective study included 30 treatment-naive patients with indolent lymphomas who underwent WB-DWIBS/STIR and conventional imaging workup plus biopsy. The pretherapeutic staging agreement, sensitivity, and specificity of WB-DWIBS/STIR were investigated with reference to the multimodality and multidisciplinary consensus review for nodal and extranodal lesions excluding bone marrow. RESULTS: In the pretherapeutic staging, WB-DWIBS/STIR showed very good agreement (κ = 0.96; confidence interval [CI], 0.88-1.00), high sensitivity (93.4-95.1%), and high specificity (99.0-99.4%) for the whole-body regions. These results were similar to those of 18F-FDG-PET/CT, except for the sensitivity for extranodal lesions. For extranodal lesions, WB-DWIBS/STIR showed higher sensitivity compared to 18F-FDG-PET/CT for the whole-body regions (94.9-96.8% vs. 79.6-86.3%, P = 0.058). CONCLUSION: WB-DWIBS/STIR is an effective modality for the pretherapeutic staging of indolent lymphoma, and it has benefits when evaluating extranodal lesions, compared with 18F-FDG-PET/CT.


Asunto(s)
Imagen de Difusión por Resonancia Magnética/métodos , Linfoma/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Imagen de Cuerpo Entero/métodos , Adulto , Anciano , Biopsia , Femenino , Fluorodesoxiglucosa F18 , Humanos , Linfoma/patología , Masculino , Persona de Mediana Edad , Imagen Multimodal/métodos , Estudios Prospectivos , Radiofármacos , Sensibilidad y Especificidad , Adulto Joven
17.
Neuroimage ; 228: 117692, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33385546

RESUMEN

Diffusion MRI (dMRI) represents one of the few methods for mapping brain fiber orientations non-invasively. Unfortunately, dMRI fiber mapping is an indirect method that relies on inference from measured diffusion patterns. Comparing dMRI results with other modalities is a way to improve the interpretation of dMRI data and help advance dMRI technologies. Here, we present methods for comparing dMRI fiber orientation estimates with optical imaging of fluorescently labeled neurofilaments and vasculature in 3D human and primate brain tissue cuboids cleared using CLARITY. The recent advancements in tissue clearing provide a new opportunity to histologically map fibers projecting in 3D, which represents a captivating complement to dMRI measurements. In this work, we demonstrate the capability to directly compare dMRI and CLARITY in the same human brain tissue and assess multiple approaches for extracting fiber orientation estimates from CLARITY data. We estimate the three-dimensional neuronal fiber and vasculature orientations from neurofilament and vasculature stained CLARITY images by calculating the tertiary eigenvector of structure tensors. We then extend CLARITY orientation estimates to an orientation distribution function (ODF) formalism by summing multiple sub-voxel structure tensor orientation estimates. In a sample containing part of the human thalamus, there is a mean angular difference of 19o±15o between the primary eigenvectors of the dMRI tensors and the tertiary eigenvectors from the CLARITY neurofilament stain. We also demonstrate evidence that vascular compartments do not affect the dMRI orientation estimates by showing an apparent lack of correspondence (mean angular difference = 49o±23o) between the orientation of the dMRI tensors and the structure tensors in the vasculature stained CLARITY images. In a macaque brain dataset, we examine how the CLARITY feature extraction depends on the chosen feature extraction parameters. By varying the volume of tissue over which the structure tensor estimates are derived, we show that orientation estimates are noisier with more spurious ODF peaks for sub-voxels below 30 µm3 and that, for our data, the optimal gray matter sub-voxel size is between 62.5 µm3 and 125 µm3. The example experiments presented here represent an important advancement towards robust multi-modal MRI-CLARITY comparisons.


Asunto(s)
Encéfalo/anatomía & histología , Sustancia Gris/anatomía & histología , Procesamiento de Imagen Asistido por Computador/métodos , Imagen Multimodal/métodos , Neuroimagen/métodos , Sustancia Blanca/anatomía & histología , Animales , Imagen de Difusión por Resonancia Magnética/métodos , Humanos , Imagenología Tridimensional/métodos , Macaca , Imagen Óptica/métodos
18.
Br J Radiol ; 94(1120): 20201170, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33439758

RESUMEN

Most of the adrenal masses are incidentally detected. Multiphasic CT forms the mainstay for diagnosis and characterization of adrenal masses. MRI can further be used if the masses are indeterminate on CT scan. But as these investigations are expensive with risk of radiation exposure, contrast-enhanced ultrasound (CEUS) is currently under evaluation to assess its utility to act as a screening modality to differentiate benign vs malignant adrenal masses This investigative modality is relatively safe and can be used in patients having renal dysfunction or allergy to CT contrast. We, hereby, present a pictorial review of imaging appearance of various adrenal lesions on CEUS with CT and MRI correlation.


Asunto(s)
Neoplasias de las Glándulas Suprarrenales/diagnóstico por imagen , Medios de Contraste , Aumento de la Imagen/métodos , Imagen por Resonancia Magnética/métodos , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía/métodos , Glándulas Suprarrenales/diagnóstico por imagen , Diagnóstico Diferencial , Humanos , Imagen Multimodal/métodos
19.
Methods Mol Biol ; 2216: 109-130, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33475997

RESUMEN

Noninvasive, robust, and reproducible methods to image kidneys are provided by different imaging modalities. A combination of modalities (multimodality) can give better insight into structure and function and to understand the physiology of the kidney. Magnetic resonance imaging can be complemented by a multimodal imaging approach to obtain additional information or include interventional procedures. In the clinic, renal ultrasound has been essential for the diagnosis and management of kidney disease and for the guidance of invasive procedures for a long time. Adapting ultrasound to preclinical requirements and for translational research, the combination with photoacoustic imaging expands the capabilities to obtain anatomical, functional, and molecular information from animal models. This chapter describes the basic concepts of how to image kidneys using different and most appropriate modalities.This chapter is based upon work from the COST Action PARENCHIMA, a community-driven network funded by the European Cooperation in Science and Technology (COST) program of the European Union, which aims to improve the reproducibility and standardization of renal MRI biomarkers. This introduction chapter is complemented by two separate chapters describing the experimental procedure and data analysis.


Asunto(s)
Biomarcadores/análisis , Enfermedades Renales/fisiopatología , Riñón/fisiología , Imagen Multimodal/métodos , Técnicas Fotoacústicas/métodos , Ultrasonografía/métodos , Animales , Riñón/diagnóstico por imagen , Enfermedades Renales/diagnóstico por imagen , Ratones , Ratas , Reproducibilidad de los Resultados , Programas Informáticos
20.
J Mater Chem B ; 9(4): 1089-1095, 2021 01 28.
Artículo en Inglés | MEDLINE | ID: mdl-33427258

RESUMEN

Near-infrared fluorophores are emerging as promising molecular tools for cancer theranostics because of their inherent biodegradability, low toxicity, and synthetic flexibility. However, they still suffer from several limitations, such as poor photostability and insufficient organelle-targeting stability during photothermal therapy. In this work, we introduce an "aldehyde functionalization" strategy for simultaneously enhancing photostability and mitochondria-immobilization of near-infrared fluorophores for the first time. Based on the proposed strategy, representative near-infrared organic molecules, namely AF-Cy, were rationally designed and synthesized. Upon aldehyde modification, the AF-Cy dyes displayed both remarkable photostability and mitochondrial-targeting stability. The strong absorption in the near-infrared region confers the AF-Cy dyes with outstanding fluorescent/photoacoustic imaging and photothermal therapy capabilities. Finally, in vitro and in vivo studies revealed the enhanced performance in inhibiting the growth of breast tumors under NIR laser radiation, and these results suggested the strong potential of AF-Cy dyes as efficient multimodal imaging-guided photothermal therapy agents, further highlighting the value of this simple strategy in the design high performance near-infrared fluorophores for tumor theranostics.


Asunto(s)
Antineoplásicos/farmacología , Neoplasias de la Mama/tratamiento farmacológico , Colorantes Fluorescentes/farmacología , Mitocondrias/efectos de los fármacos , Imagen Multimodal , Animales , Antineoplásicos/síntesis química , Antineoplásicos/química , Neoplasias de la Mama/patología , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Ensayos de Selección de Medicamentos Antitumorales , Colorantes Fluorescentes/síntesis química , Colorantes Fluorescentes/química , Rayos Infrarrojos , Neoplasias Mamarias Experimentales/tratamiento farmacológico , Neoplasias Mamarias Experimentales/patología , Ratones , Tamaño de la Partícula , Procesos Fotoquímicos , Propiedades de Superficie
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...