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1.
Praxis (Bern 1994) ; 109(2): 71-77, 2020 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-32019452

RESUMEN

CME Sonography 89: Differential Diagnosis of Kidney Masses Abstract. Cystic and solid renal lesions are common in ultrasound diagnostics. The solid pseudotumor of the kidney, the so-called renal parenchymal cone, is found in up to 50 % of patients. Pathologically-anatomically it is either a hypertrophy of the column of Bertini or the entire renal lobus, which is located in the renal sinus. Renal cysts were found in a dissected section in 50 % of those over 50 years old. The cystic lesions are subdivided into five categories with the Bosniak classification. This classification is possible with CECT, CEMR and CEUS. The solid lesions are also evaluated by these methods, but the distinction is more difficult here. By measuring the echo intensity in ultrasound, the differentiation of the hyperechoic angiomyolipomas from other solid tumors and pseudotumors is possible. In color-coded Doppler sonography (CCDS), the clear-cell renal cell carcinoma (RCC) is often depicted with many tumor vessels, the remaining tumors with few or only single vessels. In CEUS and TIC, this tumor is shown to be highly perfused, and the influx in the TIC is often faster and stronger than in the surrounding healthy renal cortex. The other tumors are mostly perfused to a lesser extent, especially the papillary carcinomas are significantly less perfused than the renal cortex.


Asunto(s)
Carcinoma de Células Renales , Enfermedades Renales Quísticas , Neoplasias Renales , Ultrasonografía , Carcinoma de Células Renales/diagnóstico por imagen , Medios de Contraste , Diagnóstico Diferencial , Humanos , Riñón , Enfermedades Renales Quísticas/diagnóstico por imagen , Neoplasias Renales/diagnóstico por imagen , Persona de Mediana Edad
2.
Medicine (Baltimore) ; 99(5): e19017, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32000446

RESUMEN

O-(2-[F]fluoroethyl)-L-tyrosine positron-emission tomography/computed tomography (F-FET PET/CT) is well known in brain tumor management. Our study aimed to identify the prognostic value of F-FET PET/CT in high-grade gliomas (HGG) according the current 2016 World Health Organization (WHO) classification.Patients with histologically proven WHO 2016 HGG were prospectively included. A dynamic F-FET PET/CT was performed allowing to obtain 2 static PET frames (static frame 1: 20-40 minutes and static frame 2: 2-22 minutes). We analyzed static parameters (standard uptake value [SUV]max, SUVmean, SUVpeak, TBRmax, TBRmean, tumoral lesion glycolysis, and metabolic tumoral volume) for various isocontours (from 10% to 90%). PET parameters, clinical features, and molecular biomarkers were compared with progression-free survival (PFS) and overall survival (OS) in univariate and multivariate analysis.Twenty-nine patients were included (grade III n = 3, grade IV n = 26). Mean PFS and OS were, respectively, 8.8 and 13.9 months. According to univariate analysis, SUVmean, SUVpeak, TBRmax, and TBRmean were significantly correlated with OS. In static 1 analysis, TBRmax seemed to be the best OS prognostic parameter (P = .004). In static 2 analysis, TBRmean was the best parameter (P = .01). In static 1 analysis, only SUVpeak was significant (P = .05) for PFS. Good performance status (PS < 2; P < .0001) and extent of resection (P = .019) identified the subgroup of patients with the best OS. Only TBRmax (P = .026) and extent of resection (P = .025) remained significant parameters in multivariate analysis.Our data suggested that high TBRmax seemed to be the most significant OS independent prognostic factor in patients with newly diagnosed HGG.


Asunto(s)
Glioma/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones , Medios de Contraste , Femenino , Glioma/patología , Glioma/cirugía , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Pronóstico , Estudios Prospectivos , Radiofármacos , Tasa de Supervivencia , Tirosina/análogos & derivados
3.
Medicine (Baltimore) ; 99(5): e19024, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32000448

RESUMEN

To assess the feasibility of using contrast-enhanced spectral mammography (CESM) for operative planning of patients with breast cancers who were initially diagnosed by sonographic guided biopsy.With the approval of the Institutional Review Board of our hospital, we retrospectively reviewed the data on patients with breast cancers who underwent CESM and contrast-enhanced magnetic resonance imaging (CE-MRI) prior to operation and were followed up for at least 5 years postoperatively. The patients with breast cancer diagnosed by sonographic guided biopsy without mammography were included for analysis. The size and number of cancers on low-energy mammograms (LE-MG), recombined subtracted mammograms (RSM), and CE-MRI were recorded and compared with microscopic histopathologic data and at least 5 years of clinical follow-up data.Fifty-one cancerous breasts of 46 patients were included in the analysis. All the principal cancers could be detected by RSM or CE-MRI; however, only 45 were by LE-MG. The Pearson correlation coefficients for the size on microscopy were 0.44 for LE-MG, 0.77 for RSM, and 0.84 for CE-MRI (all P-values ≤.001). Regarding the microscopic reports, RSM or CE-MRI had sensitivities of 100% and a positive predictive value of 63.6% for multicentric cancers. One breast cancer with partial mastectomy recurred after 3 years of follow-up.CESM was feasible for assessing the cancer extension and multicentric cancers as secondary examination in patients with diagnosed breast cancers after sonographic biopsy.


Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Imagen por Resonancia Magnética , Mamografía , Ultrasonografía Mamaria , Adulto , Anciano , Neoplasias de la Mama/cirugía , Medios de Contraste , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Gadolinio DTPA , Humanos , Biopsia Guiada por Imagen , Yohexol , Persona de Mediana Edad , Cuidados Preoperatorios , Estudios Retrospectivos , Sensibilidad y Especificidad
4.
Zhonghua Yi Xue Za Zhi ; 100(1): 42-46, 2020 Jan 07.
Artículo en Chino | MEDLINE | ID: mdl-31914557

RESUMEN

Objective: To evaluate clinical value of suspicious calcification in the diagnosis and surgical treatment of breast lesions using contrast-enhanced spectral mammography. Methods: Ninty-four patients who underwent CESM with suspicious calcification on the low-energy(LE) images in Third Affiliated Hospital of Soochow University from April 2017 to April 2019 were collected.All patients were female, with an average age of 51 years (26 to 89 years).All patients underwent biopsy or surgery to obtain pathological results. Two experienced radiologists provide BI-RADS classification for LE images and CESM. To assess pairwise agreement between BI-RADS classification on CESM and LE images among readers, kappa test were calculated. Using pathology results as the gold standard,the diagnostic efficacy of LE images and CESM were analyzed by receiver operating characteristic (ROC)curve, and Z test was used to compare the areas under the ROC curves (AUC) among them, calculated the sensitivity, specificity. The intraclass correlation coefficient (ICC) was used to analyze the consistency of the maximum image diameter and pathological diameter of malignant lesions. Two experienced radiologists provided the preferred surgical treatment (breast conservation therapy versus mastectomy) for all malignant cases according the imaging findings. McNemars test was used to compare the difference between surgical decision making and final surgical procedure. Results: One hundred and three lesions were found in 94 patients, in which 49 were benign and 54 were malignant.Overall agreement on BI-RADS classification between LE imaging and CESM among readers was substantial (0.74 vs 0.86), CESM was higher than LE images. The sensitivity of LE images and CESM were 80.4%, 96.2%, specificity was 75.0%, 94.0%, AUC were 0.810, 0.960 respectively. There was significant difference of the AUC between LE images and CESM (Z=3.66, P<0.01). The ICC of malignant lesions measured on LE images and CESM and histopathological results were 0.86 and 0.96, respectively. Based on LE images, 44.4%(24/54) of patients recommended BCT, 55.6%(30/54) of patients recommended mastectomy, the difference was statistically significant (P=0.008). Based on CESM, 27.8%(15/54) of patients recommended breast conservation therapy, 72.2%(39/54) of patients recommended mastectomy,there was no significant statistically difference with the final surgical procedure (P=0.125). Conclusion: CESM has a high diagnostic accuracy for suspicious calcification of breast. And its accuracy in assessing malignant lesion size is higher, which can provide a basis for preoperative surgical decision making.


Asunto(s)
Neoplasias de la Mama , Calcinosis , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/cirugía , Medios de Contraste , Femenino , Humanos , Mamografía , Mastectomía , Persona de Mediana Edad
5.
Zhonghua Yi Xue Za Zhi ; 100(1): 51-56, 2020 Jan 07.
Artículo en Chino | MEDLINE | ID: mdl-31914559

RESUMEN

Objective: To explore the feasibility of dynamic-enhanced magnetic resonance imaging (DCE-MRI) and blood oxygen level-dependent MRI (BOLD-MRI) in assessing the hemodynamics and tumor aggressiveness during treatment. Methods: The colon cancer xenograft model was established in BALB/C nude mice with HCT116 cell line. Sixteen nude mice were randomly divided into treatment and control groups (aged 6 to 8 weeks, weighted 15 to 18 g, Certificate No. 11400700325797), which were treated with bevacizumab and saline by intraperitoneal injection on the 1st, 4th, 7th, 10th and 13th day. DCE-MRI and BOLD-MRI were performed before and on the 3th, 6th, 9th, 12th, and 15th day after treatment. The vascular maturity and microenvironment hypoxia were confirmed by pathology. Results: The tumor volume of treatment group was significantly smaller than that of control group after 15 days ((712±43) vs (1 051±112) mm(3),P<0.01).The measurements of K(trans) were (0.135±0.005),(0.147±0.006),(0.175±0.009),(0.161±0.006), (0.140±0.005),(0.116±0.008)/min (F=81.386, P<0.01); K(ep) were (0.788±0.030),(0.804±0.036),(0.983±0.059), (1.105±0.091),(0.840±0.047),(0.786±0.041)/min(F=45.901,P<0.01);Ve were (0.652±0.006), (0.559±0.026), (0.466±0.016), (0.286±0.027), (0.363±0.020), (0.246±0.033) (F=384.290, P<0.01) and R2* values were (24.813±0.961), (24.675±1.070), (21.425±1.371), (17.850±0.885), (24.613±0.640), (27.013±0.734)/s (F=89.323, P<0.01) showed different trends with time in the treatment group, and the differences were statistically significant. The K(trans) values and tumor vessel maturity index (VMI) were higher than baseline values during 3-12 d after treatment. CD31 positive staining rate and VMI had the strongest correlations with K(trans) values (r=0.854 and 0.795), followed by AUC(180) (r=0.750 and 0.808), Ve (r=0.744 and 0.712) and K(ep) values (r=0.729 and 0.758), all P<0.05. R2* value positively correlated with the positive staining rate of HIF-1α and fibronectin (r=0.810 and 0.816), all P<0.05. Conclusion: DCE-MRI and BOLD-MRI are adequate to observe the tumor perfusion and hypoxia during anti-vascular treatment, and the R2* value can predict the tumor metastatic potential during the process of vascular normalization.


Asunto(s)
Medios de Contraste , Imagen por Resonancia Magnética , Animales , Xenoinjertos , Ratones , Ratones Endogámicos BALB C , Ratones Desnudos
6.
J Comput Assist Tomogr ; 44(1): 7-12, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31939875

RESUMEN

OBJECTIVE: The aim of the study was to investigate the feasibility of coronary computed tomography (CT) angiography with a low kilovoltage peak scan and a refined scan timing prediction using a small contrast medium (CM) dose. METHODS: In protocol A, 120-kVp scanning and a standard CM dose were used. The scan timing was fixed. In protocol B, 80 kVp and a 60% CM dose were used. The scan timing was determined according to the interval from the CM arrival to the peak time in the ascending aorta. We measured the CT number and recorded the radiation dose. RESULTS: Higher CT numbers were observed in the left circumflex (proximal, P = 0.0235; middle, P = 0.0007; distal, P < 0.0001) in protocol B compared with protocol A. The radiation dose in protocol B was significantly lower than in protocol A (2.2 ± 0.9 vs 4.3 ± 1.7 mSv). CONCLUSIONS: Low-contrast, low-radiation dose, high-image quality coronary CT angiography can be performed with low kilovoltage peak scanning and a refined scan timing prediction.


Asunto(s)
Angiografía por Tomografía Computarizada/métodos , Medios de Contraste/administración & dosificación , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Intensificación de Imagen Radiográfica/métodos , Anciano , Cálculo de Dosificación de Drogas , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dosis de Radiación , Estudios Retrospectivos
7.
J Comput Assist Tomogr ; 44(1): 13-19, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31939876

RESUMEN

OBJECTIVE: To evaluate image quality and radiation dose exposure of low-kV setting and low-volume contrast medium (CM) computed tomography angiography (CTA) protocol for transcatheter aortic valve implantation (TAVI) planning in comparison with standard CTA protocol. METHODS: Sixty-patients were examined with 256-row MDCT for TAVI planning: 32 patients (study group) were evaluated using 80-kV electrocardiogram-gated protocol with 60 mL of CM and IMR reconstruction; 28 patients underwent a standard electrocardiogram-gated CTA study (100 kV; 80 mL of CM; iDose4 reconstruction). Subjective and objective image quality was evaluated in each patient at different aortic levels. Finally, we collected radiation dose exposure data (CT dose index and dose-length product) of both groups. RESULTS: In study protocol, significant higher mean attenuation values were achieved in all measurements compared with the standard protocol. There were no significant differences in the subjective image quality evaluation in both groups. Mean dose-length product of study group was 56% lower than in the control one (P < 0.0001). CONCLUSION: Low-kV and low-CM volume CTA, combined with IMR, allows to correctly performing TAVI planning with high-quality images and significant radiation dose reduction compared with standard CTA protocol.


Asunto(s)
Estenosis de la Válvula Aórtica/diagnóstico por imagen , Angiografía por Tomografía Computarizada/métodos , Medios de Contraste/administración & dosificación , Interpretación de Imagen Radiográfica Asistida por Computador/métodos , Adulto , Anciano , Anciano de 80 o más Años , Algoritmos , Estenosis de la Válvula Aórtica/cirugía , Femenino , Humanos , Bases del Conocimiento , Masculino , Persona de Mediana Edad , Tomografía Computarizada Multidetector , Periodo Preoperatorio , Dosis de Radiación , Reemplazo de la Válvula Aórtica Transcatéter
8.
J Comput Assist Tomogr ; 44(1): 95-101, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31939889

RESUMEN

PURPOSE: This study aimed to evaluate image quality of ultra-low dose chest computed tomography using 6 iterative reconstruction (IR) algorithms. METHOD: A lung phantom was scanned on 4 computed tomography scanners using fixed tube voltages and the lowest mAs available on each scanner, resulting in dose levels of 0.1 to 0.2 mGy (80 kVp) and 0.3 to 1 mGy (140 kVp) volume CT dose index (CTDIvol). Images were reconstructed with IR available on the scanners. Image noise, signal-to-noise ratios, contrast-to-noise ratios, uniformity, and noise power spectrum (NPS) were assessed for evaluation of image quality. RESULTS: Image quality parameters increased with increasing dose for all algorithms. At constant dose levels, model-based techniques improved the contrast-to-noise ratio of lesions more than the statistical algorithms. All algorithms tested at 0.1 mGy showed lower NPS peak frequencies compared with 0.39 mGy. In contrast to the statistical techniques, model-based algorithms showed lower NPS peak frequencies at the lowest doses, indicating a coarser and blotchier noise texture. CONCLUSION: This study shows the importance of evaluating IR when introduced clinically.


Asunto(s)
Pulmón/diagnóstico por imagen , Interpretación de Imagen Radiográfica Asistida por Computador/métodos , Tomografía Computarizada por Rayos X/instrumentación , Algoritmos , Medios de Contraste , Humanos , Fantasmas de Imagen , Dosis de Radiación , Relación Señal-Ruido
9.
J Zoo Wildl Med ; 50(4): 891-896, 2020 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-31926520

RESUMEN

Clinical assessment of renal function in avian species often involves the measurement of plasma uric acid and blood urea nitrogen, relatively insensitive markers of renal dysfunction and dehydration. In mammals, endogenous creatinine is widely used as an indicator of renal glomerular dysfunction. However, avian species produce primarily creatine. Here, renal creatine, 99mTc99-DTPA (diethylenepentaacetic acid, DTPA) and 99mTc-MAG3 (mercaptoacetyl triglycine, MAG3) renal clearances are characterized in the pigeon avian model by infusing DTPA with inulin and creatine with each tracer and examining the slope of their blood disappearance curves. Clearance curves for inulin and DTPA were parallel, suggesting DTPA is cleared by renal filtration. MAG3 clearance (slope: -2.74 × 105, r2 = 0.97) had a slope almost 10-fold steeper than for DTPA (slope: -6.29 × 104, r2 = 0.90), and orders of magnitude steeper than for creatine (slope: -1.4, r2 = 1.0). These results suggest that DTPA is cleared by glomerular filtration like inulin, while MAG3 is filtered and actively excreted in a manner similar to mammals. In contrast, creatine is filtered and resorbed, has a larger volume of distribution (Vd), or exhibits a greater blood protein binding, making it more complex as a renal marker, when compared with creatinine handling in mammals. The two radiotracers can be readily adapted for use in birds, inviting both qualitative and semiquantitative functional evaluation of avian renal function for research and clinical purposes. The elimination of creatine appears to be more complex requiring further study.


Asunto(s)
Columbidae/metabolismo , Creatina/metabolismo , Riñón/metabolismo , Oligopéptidos/metabolismo , Ácido Pentético/farmacocinética , Polietileneimina/análogos & derivados , Animales , Medios de Contraste/farmacocinética , Polietileneimina/farmacocinética
10.
Artículo en Japonés | MEDLINE | ID: mdl-31956186

RESUMEN

In the tissue characterization of plaques using magnetic resonance imaging (MRI), T1-weighted imaging is important. However, T1-weighted imaging are obtained by various imaging methods, and show different contrasts depending on parameters such as repetition time, echo time, and inversion time. To evaluate the tissue characterization of plaques using MRI, the characteristics are estimated and evaluated using the strength of the plaque-to-muscle signal intensity ratio (PMR), which is the value obtained by dividing the signal intensity of the plaque by that of the sternocleidomastoid muscle or myocardium. In the present research, we aim to obtain the PMR by phantom experiment and grasp the image characteristics for T1 and T2 values of different T1-weighted imaging methods. In addition, since the PMR of the conventional spin echo (SE) method of T1-weighted imaging (two-dimensional (2D) T1WI SE) is reported to have high discrimination ability in plaque tissue characterization, the experimental results were compared with those of 2D T1WI SE. Among the protocols examined, 3D sampling perfection with application optimized contrasts using different flip angle evolutions, T1-variable, motion-sensitized driven equilibrium (1-axis 300 ms2*mT/m) + had the same tissue characterization ability as 2D T1 WI SE, and was the most suitable imaging method. Moreover, in the gradient echo method, the effect of T2 values was smaller than that of 2D T1 WI SE, and it was suggested that the PMR of the plaque may be lowered when there is a change in the tissue properties that the T2 value and T1 value are prolonged due to liquefaction. The results of this phantom experiment are expected help in selecting the imaging method aimed at optimization and the image characteristics of different T1-weighted imaging method can be grasped.


Asunto(s)
Imagen Tridimensional , Imagen por Resonancia Magnética , Placa Aterosclerótica , Medios de Contraste , Humanos , Fantasmas de Imagen , Placa Aterosclerótica/diagnóstico por imagen
11.
World Neurosurg ; 133: e513-e521, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31550541

RESUMEN

OBJECTIVE: Owing to technical development of specific fluorophore filters, the neurosurgical application of sodium fluorescein (SF) has regained value in brain tumor surgery. The aim of this study was to determine the usefulness of SF during nerve biopsies. METHODS: This single-center study included 5 cases of nerve biopsies performed under microscope-based fluorescence with SF performed between March 2016 and February 2017. SF was applied intravenously (1 mg/kg body weight). After microsurgical dissection of the involved nerve segment, fluorescence-guided fascicular biopsy was performed. Selection of target fascicles was at the surgeon's discretion and took into account nerve stimulation for preservation of motor function and fluorescence intensity. Correlation to histopathologic examination was examined. Video analysis of intraoperative images comparing target fascicles with intense fluorescent response to adjacent fascicles of the same nerve segment was performed using ImageJ. RESULTS: All patients had motor or sensory deficits. Magnetic resonance imaging findings were similar, depicting long segments of gadolinium enhancement (minimum 11.7 cm). Each biopsy sample was positive resulting in diverse histopathologic results. Digital image analysis revealed a statistically significant difference of the complementary color green (P = 0.0473). CONCLUSIONS: Magnetic resonance imaging is the gold standard in diagnostic work-up of peripheral nerve disorders. Longitudinal nerve thickening with positive contrast enhancement is an unspecific magnetic resonance imaging finding. Various pathologies, such as tumors and inflammatory lesions, may cause this morphologic phenomenon. Nerve biopsies may be needed for diagnostic work-up. Intraoperative SF may help to depict the most affected fascicles and identify target fascicles for biopsy and increase diagnostic certainty of nerve biopsies.


Asunto(s)
Biopsia/métodos , Medios de Contraste , Fluoresceína , Procedimientos Neuroquirúrgicos/métodos , Enfermedades del Sistema Nervioso Periférico/diagnóstico , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad
12.
Angiology ; 71(2): 183-188, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-30987432

RESUMEN

We investigated the preventive effect of nicorandil on contrast-induced nephropathy (CIN) in patients with moderate renal insufficiency undergoing percutaneous coronary intervention (PCI). A total of 250 patients with a creatinine clearance (crCl) ≤60 mL/min undergoing PCI were randomly assigned to either a nicorandil group (nicorandil 10 mg 3 times/d and hydration; n = 125) or a control group (hydration only; n = 125). The first end point was the incidence of CIN defined as an increase in serum creatinine (Scr) levels by ≥0.5 mg/dL or ≥25% within 72 hours after exposure to the contrast medium. The secondary end points were (1) changes in Scr, blood urea nitrogen, and crCl and (2) the incidence of major adverse events during hospitalization. The incidence of CIN was 1.6% (2/125) in the nicorandil group and 9.6% (12/125) in the control group (P = .011). There was no obvious difference in the incidence of major adverse events during hospitalization between the nicorandil and the control group (4.0% vs 4.8%, P = 1.000). Multivariate logistic regression analysis showed that nicorandil was a protective factor for CIN (odds ratios = 0.126, 95% confidence interval: -19.996 to -0.932, P = .012). Prophylactic administration of nicorandil may prevent against CIN in patients with moderate renal insufficiency undergoing PCI.


Asunto(s)
Enfermedades Renales/inducido químicamente , Enfermedades Renales/prevención & control , Nicorandil/uso terapéutico , Intervención Coronaria Percutánea , Insuficiencia Renal/complicaciones , Anciano , Medios de Contraste/efectos adversos , Femenino , Humanos , Masculino , Índice de Severidad de la Enfermedad
13.
J Photochem Photobiol B ; 202: 111669, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31739258

RESUMEN

Herein we report the synthesis and characterization of the antifouling Gadolinium oxide (Gd2O3) nanoparticles (NPs) modified with PEG with improved biocompatibility for MR imaging purposes. In this report, using the solvothermal decomposition of Gadolinium (III) in the presence of Na3cit, monitored by surface modification with PEG and L-Cys. The synthesized nanoparticles were confirmed by the TEM, DLS and UV-Visible spectroscopy. The morphological results show normal distance across of the flawless Gd2O3-PEG-Cys-NPs show 7.9 ±â€¯0.4 nm, discretely, with a thin size exchange. This infers the surface adjustment does not obviously alteration the center size of the Gd2O3-NPs when contrasted with the perfect sodium citrate-balanced out Gd2O3-NPs. The Gd2O3-PEG-L-Cys-NPs are highly stable at room temperature, water dispersible and importantly less cytotoxic at high concentration of the NPs. The T1-weighted MR phantasm readings evidentially displayed that the formed PEG coated Gd2O3-PEG and Gd2O3-PEG-Cys-NPs with and without Cys may be performed as the promising T1-weighted MR imaging. The NPs displays no signs of toxicity against the human blood, which represents the biocompatibility for the human medicine applications. The Gd2O3-PEG-Cys-NPs shows relatively, high r1 acceptable cytocompatibility, target specific cancer cells and activate the dual mode MR imaging of lung metastasis cancer model in vitro. The development of versatile zwitterion functionalized Gd2O3 may be promising as an active nanoparticle probe for improved multi-model of MR imaging agents for various cancer diseases.


Asunto(s)
Medios de Contraste/química , Gadolinio/química , Neoplasias Pulmonares/diagnóstico por imagen , Imagen por Resonancia Magnética , Nanopartículas/química , Polietilenglicoles/química , Animales , Materiales Biocompatibles/química , Materiales Biocompatibles/farmacología , Línea Celular Tumoral , Supervivencia Celular/efectos de los fármacos , Cisteína/química , Hemólisis/efectos de los fármacos , Humanos , Neoplasias Pulmonares/secundario , Melanoma Experimental/patología , Ratones , Nanopartículas/toxicidad , Células RAW 264.7 , Trasplante Homólogo
15.
Toxicol Lett ; 318: 65-73, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31654803

RESUMEN

OBJECTIVE: The optimal measuring timing of serum/plasma Cystatin C (CysC) for early detection of contrast-induced acute kidney injury (CIAKI) remains un-studied. We elucidated further on this issue. METHODS: We searched PubMed, MEDLINE, and Embase from inception until March 2018 for studies evaluating diagnostic accuracy of CysC for detecting CIAKI in patients exposed to contrast agents during diagnostic examinations or cardiac/peripheral catheterizations. RESULTS: A total of 10 relevant studies, comprising 2554 patients, were included and divided into the <24 -h and 24 -h groups based on CysC measuring timing (i.e., hours after contrast agent exposure). Compared with creatinine, pooled diagnostic odds ratio of CysC for detecting CIAKI of the <24 -h and 24 -h groups was 7.59 (95 % confidence interval [CI]: 1.31-44.08) and 53.81 (95 % CI: 13.57-213.26). Pooled sensitivity of the <24 -h and 24 -h groups was 0.81 and 0.88. Pooled specificity of the <24 -h and 24 -h groups was 0.64 and 0.88, respectively. Area under the hierarchical summary receiver operating characteristic curve of the <24 -h and 24 -h groups was 0.75 and 0.93. CONCLUSIONS: Measuring CysC at 24 h after contrast agent exposure shows higher diagnostic accuracy for early detection of CIAKI than measuring CysC at <24 h after contrast agent exposure.


Asunto(s)
Lesión Renal Aguda/diagnóstico , Medios de Contraste/efectos adversos , Cistatina C/sangre , Lesión Renal Aguda/sangre , Lesión Renal Aguda/inducido químicamente , Anciano , Biomarcadores/sangre , Diagnóstico Precoz , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Factores de Tiempo
16.
Radiol Clin North Am ; 58(1): 93-103, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31731905

RESUMEN

This article describes an approach to analyzing the distribution of intravenous contrast on chest computed tomography and illustrates the various pathologies and pitfalls that may be encountered by the imager, especially in the hospitalized patient. Understanding normal and abnormal distribution of intravenous contrast can be used as a clue to detect alterations in physiology and flow.


Asunto(s)
Medios de Contraste , Cardiopatías/diagnóstico por imagen , Pacientes Internos , Embolia Pulmonar/diagnóstico por imagen , Intensificación de Imagen Radiográfica , Tomografía Computarizada por Rayos X/métodos , Corazón/diagnóstico por imagen , Hospitalización , Humanos , Pulmón/diagnóstico por imagen , Radiografía Torácica/métodos
18.
Br J Radiol ; 93(1105): 20190543, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31617743

RESUMEN

OBJECTIVE: MR-perfusion post-processing still lacks standardization. This study evaluates the results of perfusion analysis with two established software solutions in a large series of patients with different diseases when a highly standardized processing workflow is ensured. METHODS: Multicenter data of 260 patients (80 with brain tumors, 124 with cerebrovascular disease and 56 with dementia examined with the same MR protocol) were analyzed. Raw data sets were processed with two software suites: Olea sphere and NordicICE. Group differences were analyzed with paired t-tests and one-way ANOVA. RESULTS: Perfusion metrics were significantly different for all examined diseases in the unaffected brain for both software suites [ratio cortex/white matter left hemisphere: mean transit time (MTT) 0.991 vs 0.847, p < 0.05; relative cerebral bloodflow (rBF) 3.23 vs 4.418, p < 0.001; relative cerebral bloodvolume (rBVc) 2.813 vs 3.884, p < 0.001; right hemisphere: MTT 1.079 vs 0.854, p < 0.05; rBF 3.262 vs 4.378, p < 0.001; rBVc 2.762 vs 3.935, p < 0.001)]. Perfusion results were also significantly different in patients with stroke (ratio cortex/white matter affected hemisphere: MTT 1.058 vs 0.784; p < 0.001), dementia (ratio cortex/white matter left hemisphere: rBVc 1.152 vs 1.795, p < 0.001; right hemisphere: rBVc 1.396 vs 1.662, p < 0.05) and brain tumors (ratio cortex/whole tumor rBVc: 0.778 vs 0.919, p < 0.001 and ratio cortex/tumor hotspot rBVc: 0.529 vs 0.512, p < 0.05). CONCLUSION: Despite a highly standardized workflow, parametric perfusion maps are depended on the chosen software. Radiologists should consider software related variances when using dynamic susceptibility contrast perfusion for clinical imaging and research. ADVANCES IN KNOWLEDGE: This multicenter study compared perfusion parameters calculated by two commercial dynamic susceptibility contrast perfusion post-processing software solutions in different central nervous system disorders with a large sample size and a highly standardized processing workflow. Despite, parametric perfusion maps are depended on the chosen software which impacts clinical imaging and research.


Asunto(s)
Neoplasias Encefálicas/diagnóstico por imagen , Trastornos Cerebrovasculares/diagnóstico por imagen , Demencia/diagnóstico por imagen , Interpretación de Imagen Asistida por Computador/métodos , Angiografía por Resonancia Magnética/métodos , Programas Informáticos , Circulación Cerebrovascular , Medios de Contraste , Femenino , Humanos , Masculino , Compuestos Organometálicos , Perfusión
19.
Br J Radiol ; 93(1105): 20190719, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31670571

RESUMEN

OBJECTIVE: To compare therapeutic outcomes between hepatic resection (HR) and radiofrequency ablation (RFA) for small hepatic masses diagnosed as hepatocellular carcinoma (HCC) on pre-treatment imaging study. METHODS: Our institutional review board approved this retrospective study, and informed consent was waived. Patients with a single (≤3 cm) mass diagnosed as HCC on pre-treatment imaging study between January 2008 and December 2009 who underwent HR (n = 145) or RFA (n = 178) were included. Recurrence-free survival (RFS) and overall survival (OS) were assessed. In the HR group, the false-positive rate for imaging diagnosis was calculated. For the RFA group, the local tumor progression rate was calculated. RESULTS: RFS rates at 5 years were 59.3% for the HR group and 32.2% for the RFA group. OS rates at 5 years were 85.4% for the HR group and 76.8% for the RFA group. In the RFA group, cumulative local tumor progression rates were 8.3 and 20.2% at 1 and 3 years. Treatment modality was not an independent prognostic factor for either RFS or OS on multivariate analysis. The false-positive rate for HCC diagnosis based on imaging criteria was 4.8% in the HR group. CONCLUSION: The imaging criteria for diagnosis of HCC have a high positive predictive value. Multivariate analysis showed that RFS and OS rates were not significantly different between HR and RFA for small hepatic masses diagnosed as HCC on pre-treatment imaging. ADVANCES IN KNOWLEDGE: Treatment modality (hepatic resection vs RFA) was not an independent prognostic factor for both RFS and OS for small masses (≤3 cm) diagnosed as hepatocellular carcinoma on pre-treatment imaging.


Asunto(s)
Carcinoma Hepatocelular/diagnóstico por imagen , Carcinoma Hepatocelular/cirugía , Hepatectomía , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/cirugía , Ablación por Radiofrecuencia , Biomarcadores de Tumor/sangre , Medios de Contraste , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tomografía Computarizada por Rayos X
20.
Br J Radiol ; 93(1105): 20190375, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31670572

RESUMEN

OBJECTIVES: We aimed to identify dynamic CT features that can be used for prediction of local recurrence of hepatocellular carcinoma (HCC) after proton beam therapy (PBT). METHODS: We retrospectively retrieved CT scans of patients with PBT-treated HCC, taken between January 2004 and December 2016. 17 recurrent lesions and 34 non-recurrent lesions were retrieved. The attenuation difference between irradiated tumor and irradiated parenchyma (ADHCC-IP) was compared in the two groups by using the Mann-Whitney U test. Cut-off value of ADHCC-IP was estimated by using the Youden index. RESULTS: The follow-up time after PBT initiation ranged from 374 to 2402 days (median, 1069 days) in recurrent lesions, and 418 to 2923 days (median, 1091.5 days) in non-recurrent lesions (p = 0.892). The time until appearance of local recurrence after PBT initiation ranged from 189 to 2270 days (median, 497 days). ADHCC-IP of recurrent lesions [mean, -21.8 Hounsfield units (HU); from -95 to -31 HU] was significantly greater than that of non-recurrent lesions (mean, -51.7 HU; from -117 to -12 HU) at 1-2 years in portal venous phase (p = 0.039). 5-year local tumor control rates were 0.93 and 0.56 in lesions with ADHCC-IP at 1-2 years in PVP < -55 and ≥ -55 HU, respectively. CONCLUSION: The attenuation difference between irradiated HCC and irradiated liver parenchyma in portal venous phase at 1-2 years after PBT can predict long-term local recurrence of HCC after treatment. ADVANCES IN KNOWLEDGE: We identified a cut-off value for contrast enhancement of HCC after PBT that could predict future local recurrence.


Asunto(s)
Carcinoma Hepatocelular/radioterapia , Neoplasias Hepáticas/radioterapia , Recurrencia Local de Neoplasia/diagnóstico por imagen , Recurrencia Local de Neoplasia/patología , Terapia de Protones , Tomografía Computarizada por Rayos X/métodos , Anciano , Carcinoma Hepatocelular/patología , Medios de Contraste , Femenino , Humanos , Neoplasias Hepáticas/patología , Masculino , Estudios Retrospectivos
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