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1.
Clin Med Insights Oncol ; 17: 11795549231207833, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38023285

RESUMO

Background: The 2019 European Society of Urogenital Radiology (ESUR) guidelines for endometrial cancer recommend performing either dynamic contrast-enhanced magnetic resonance imaging (CE MRI) or single-phase CE MRI. However, no study has directly compared these options. Therefore, this study compared dynamic versus single-phase CE MRI for the evaluation of myometrial invasion in women with endometrial cancer. Methods: This retrospective, single-institution comparative study was conducted among women with surgically proven endometrial cancer, including 30 consecutive women with single-phase CE MRI and 30 age- and pathologic stage-matched women with dynamic CE MRI. Three readers independently compared dynamic and single-phase CE MRI in terms of the tumor-myometrium signal intensity (SI) difference ratio, depth of myometrial invasion, image quality, and image number. Pathologic findings served as a reference standard for the depth of myometrial invasion. Results: The estimated mean SI difference ratios of dynamic CE MRI and single-phase CE MRI fell within an equivalence margin of 0.05 (90% confidence intervals [CIs] = [-0.0497 to -0.0165], [-0.0226 to -0.0403], and [-0.0429 to -0.0433], respectively, for readers A, B, and C). The area under the receiver operating characteristic curve for the detection of deep myometrial invasion was not significantly different between the acquisitions (P = .3315, P = .3345, and P = .8593, respectively). Single-phase CE MRI showed significantly better image quality than dynamic CE MRI (P = .0143, P = .0042, and P = .0066, respectively), while the median number of images for dynamic CE MRI was 2.4 times higher than that for single-phase CE MRI. Conclusion: Single-phase acquisition may be a better option for CE MRI in women with endometrial cancer than dynamic acquisition.

2.
Eur J Radiol ; 150: 110276, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35339860

RESUMO

PURPOSE: To compare CE MRI and DWI in the risk stratification of women with endometrial cancer for lymph node metastasis. METHOD: Two readers independently assessed the degree of myometrial invasion on two separate occasions in a retrospective cohort of 84 women with endometrial cancers: once with CE MRI and standard anatomic sequences and another time with DWI and standard anatomic sequences. Participants were stratified according to their risk of lymph node metastasis following the European Society for Medical Oncology guidelines. The rate of lymph node metastasis was compared between the risk stratification groups obtained using CE MRI or DWI by generalized estimating equations. RESULTS: In the low-risk group, the rate of lymph node metastasis was 1.9% (1/53) when using CE MRI and 1.9% (1/54) when using DWI for reader 1, and 3.8% (2/52) when using CE MRI and 1.9% (1/52) when using DWI for reader 2. The rate of lymph node metastasis in the high-risk group was 25.8% (8/31) when using CE MRI and 26.7% (8/30) when using DWI for reader 1, and 21.9% (7/32) when using CE MRI and 25.0% (8/32) when using DWI for reader 2. There was no significant difference between CE MRI and DWI in the rate of lymph node metastasis according to the risk stratification (p > .05 in both low- and high-risk groups for both readers). CONCLUSION: DWI might be a comparable alternative to CE MRI in the preoperative risk stratification of women with endometrial cancer for lymph node metastasis.


Assuntos
Meios de Contraste , Neoplasias do Endométrio , Imagem de Difusão por Ressonância Magnética/métodos , Neoplasias do Endométrio/diagnóstico por imagem , Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/cirurgia , Feminino , Humanos , Metástase Linfática/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Estudos Retrospectivos , Medição de Risco , Sensibilidade e Especificidade
3.
J Sci Food Agric ; 102(9): 3503-3512, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35218028

RESUMO

As consumer needs change, innovative food processing techniques are being developed that have minimal impact on food quality and ensure its microbiological safety. Sous vide (SV) is an emerging technology of cooking foods in vacuum pouches at specific temperatures, which results in even heat distribution. Presented here is an overview of the current state of the art in the application of SV techniques for processing and preserving foods. Unlike the conventional thermal food processing approach, the precise nature of the SV method improves food quality, nutrition and shelf-life while destroying microorganisms. Foods processed by SV are usually subjected to temperatures between 50 and 100 °C. Although sufficient for food preparation/processing, its effectiveness in eliminating microbial pathogens, including viruses, parasites, vegetative and spore forms of bacteria, is limited. However, the inactivation of spore-forming microbes can be enhanced by combining the technique with other non-thermal methods that exert negligible impact on the nutritional, flavour and sensory characteristics of foods. In addition to exploring the mechanism of action of SV technology, the challenges related to its implementation in the food industry are also discussed. SV method potential, applications, and impacts on spore-forming microbes and spore inactivation are explored in this review. Through the debate and discussion presented, further research and industrial applications of this food processing method could be guided. © 2022 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.


Assuntos
Culinária , Inocuidade dos Alimentos , Culinária/métodos , Manipulação de Alimentos/métodos , Paladar , Vácuo
4.
Eur Radiol ; 32(4): 2506-2517, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34647178

RESUMO

OBJECTIVES: To investigate useful MRI features in pancreatic neuroendocrine tumor (PNET) patients for predicting recurrence and its timing after surgery. METHODS: A total of 99 patients with PNET who underwent MRI and surgery from 2000 to 2018 were enrolled. Two radiologists independently assessed MRI findings, including size, location, margin, T1 and T2 signal intensity, enhancement patterns, common bile duct (CBD) or main pancreatic duct (MPD) dilatation, vascular invasion, lymph node enlargement, DWI, and ADC value. Imaging findings associated with recurrence and disease-free survival (DFS) were assessed using logistic regression analysis and Cox proportional hazard regression analysis. RESULTS: The median follow-up period was 40.4 months, and recurrence after surgery occurred in 12.1% (12/99). Among them, 6 patients experienced recurrence within 1 year, and 9 patients experienced recurrence within 2 years after surgery. In multivariate analysis, major venous invasion (OR 10.76 [1.14-101.85], p = 0.04) was associated with recurrence within 1 year, and portal phase iso- to hypoenhancement (OR 51.89 [1.73-1557.89], p = 0.02), CBD or MPD dilatation (OR 10.49 [1.35-81.64], p = 0.03) and larger size (OR 1.05 [1.00-1.10], p = 0.046) were associated with recurrence within 2 years. The mean DFS was 116.4 ± 18.5 months, and the 5-year DFS rate was 85.7%. In multivariate analysis, portal phase iso- to hypoenhancement (HR 21.36 [2.01-197.77], p = 0.01), ductal dilatation (HR 5.22 [1.46-18.68], p = 0.01), major arterial invasion (HR 42.90 [3.66-502.48], p = 0.003), and larger size (HR 1.04 [1.01-1.06], p = 0.01) showed a significant effect on poor DFS. CONCLUSION: MRI features, including size, enhancement pattern, vascular invasion, and ductal dilatation, are useful in predicting recurrence and poor DFS after surgery in PNET. Key Points • MRI features are useful for predicting prognosis in patients with PNET after surgery. • PV or SMV invasion (OR 10.49 [1.35-81.64], p = 0.04) was significantly associated with 1-year recurrence. • Portal phase iso- to hypoenhancement (HR 21.36), CBD or MPD dilatation (HR 5.22), arterial invasion (HR 42.90), and larger size (HR 1.04) had significant effects on poor DFS (p < 0.05).


Assuntos
Tumores Neuroendócrinos , Neoplasias Pancreáticas , Humanos , Imageamento por Ressonância Magnética/métodos , Margens de Excisão , Tumores Neuroendócrinos/diagnóstico por imagem , Tumores Neuroendócrinos/patologia , Tumores Neuroendócrinos/cirurgia , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/cirurgia , Prognóstico , Estudos Retrospectivos
5.
Sci Rep ; 11(1): 20390, 2021 10 14.
Artigo em Inglês | MEDLINE | ID: mdl-34650183

RESUMO

Our objective was to investigate the feasibility of deep learning-based synthetic contrast-enhanced CT (DL-SCE-CT) from nonenhanced CT (NECT) in patients who visited the emergency department (ED) with acute abdominal pain (AAP). We trained an algorithm generating DL-SCE-CT using NECT with paired precontrast/postcontrast images. For clinical application, 353 patients from three institutions who visited the ED with AAP were included. Six reviewers (experienced radiologists, ER1-3; training radiologists, TR1-3) made diagnostic and disposition decisions using NECT alone and then with NECT and DL-SCE-CT together. The radiologists' confidence in decisions was graded using a 5-point scale. The diagnostic accuracy using DL-SCE-CT improved in three radiologists (50%, P = 0.023, 0.012, < 0.001, especially in 2/3 of TRs). The confidence of diagnosis and disposition improved significantly in five radiologists (83.3%, P < 0.001). Particularly, in subgroups with underlying malignancy and miscellaneous medical conditions (MMCs) and in CT-negative cases, more radiologists reported increased confidence in diagnosis (83.3% [5/6], 100.0% [6/6], and 83.3% [5/6], respectively) and disposition (66.7% [4/6], 83.3% [5/6] and 100% [6/6], respectively). In conclusion, DL-SCE-CT enhances the accuracy and confidence of diagnosis and disposition regarding patients with AAP in the ED, especially for less experienced radiologists, in CT-negative cases, and in certain disease subgroups with underlying malignancy and MMCs.


Assuntos
Dor Abdominal/diagnóstico por imagem , Aprendizado Profundo , Serviço Hospitalar de Emergência , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Dor Aguda/diagnóstico , Dor Aguda/diagnóstico por imagem , Dor Aguda/etiologia , Adulto , Idoso , Algoritmos , Meios de Contraste , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
6.
Eur Radiol ; 31(9): 6889-6897, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33740095

RESUMO

OBJECTIVES: For patients with pancreatic adenocarcinoma (PAC), adequate determination of disease extent is critical for optimal management. We aimed to evaluate diagnostic accuracy of CT in determining the resectability of PAC based on 2020 NCCN Guidelines. METHODS: We retrospectively enrolled 368 consecutive patients who underwent upfront surgery for PAC and preoperative pancreas protocol CT from January 2012 to December 2017. The resectability of PAC was assessed based on 2020 NCCN Guidelines and compared to 2017 NCCN Guidelines using chi-square tests. Overall survival (OS) was estimated using the Kaplan-Meier method and compared using log-rank test. R0 resection-associated factors were identified using logistic regression analysis. RESULTS: R0 rates were 80.8% (189/234), 67% (71/106), and 10.7% (3/28) for resectable, borderline resectable, and unresectable PAC according to 2020 NCCN Guidelines, respectively (p < 0.001). The estimated 3-year OS was 28.9% for borderline resectable PAC, which was significantly lower than for resectable PAC (43.6%) (p = 0.004) but significantly higher than for unresectable PAC (0.0%) (p < 0.001). R0 rate was significantly lower in patients with unresectable PAC according to 2020 NCCN Guidelines (10.7%, 3/28) than in those with unresectable PAC according to the previous version (31.7%, 20/63) (p = 0.038). In resectable PAC, tumor size ≥ 3 cm (p = 0.03) and abutment to portal vein (PV) (p = 0.04) were independently associated with margin-positive resection. CONCLUSIONS: The current NCCN Guidelines are useful for stratifying patients according to prognosis and perform better in R0 prediction in unresectable PAC than the previous version. Larger tumor size and abutment to PV were associated with margin-positive resection in patients with resectable PAC. KEY POINTS: • The updated 2020 NCCN Guidelines were useful for stratifying patients according to prognosis. • The updated 2020 NCCN Guidelines performed better in the prediction of margin-positive resection in unresectable cases than the previous version. • Tumor size ≥ 3 cm and abutment to the portal vein were associated with margin-positive resection in patients with resectable pancreatic adenocarcinoma.


Assuntos
Adenocarcinoma , Neoplasias Pancreáticas , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Humanos , Estadiamento de Neoplasias , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/cirurgia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
7.
Abdom Radiol (NY) ; 46(7): 3217-3226, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33713160

RESUMO

PURPOSE: To compare lesion conspicuity and image quality of arterial phase images obtained from low kVp (90-kVp) and dual-energy (DE) scans for the evaluation of hypervascular hepatocellular carcinoma (HCC). METHODS: This retrospective study included 229 patients with HCC who underwent either 90 kVp (n = 106) or DE scan (80- and 150-kVp with a tin filter) (n = 123) during the arterial phase. DE scans were reconstructed into a linearly blended image with a mixed ratio of 0.6 (60% 80kVp and 40% 150 kVp) and post-processed for 40 keV and 50 keV images. The contrast-to-noise ratio (CNR) of HCC to the liver and image noise was measured. Lesion conspicuity, liver parenchymal image quality, and overall image preference were assessed qualitatively by three independent radiologists. RESULTS: DE 40 keV images had the highest CNR of HCC, and DE blended images had the lowest image noise among four image sets (p = 0.01 and p < 0.001, respectively). There was no significant difference in mean volume CT dose index and dose-length product between DE and low kVp scan (ps > 0.05). For qualitative analyses, DE blended images had the highest scores for image quality and overall image preference (ps < 0.001). CONCLUSION: At an equal radiation dose, DE 40 keV showed higher CNR of HCC and DE blended image showed higher image quality and image preference compared with low kVp CT.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Carcinoma Hepatocelular/diagnóstico por imagem , Meios de Contraste , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Doses de Radiação , Interpretação de Imagem Radiográfica Assistida por Computador , Estudos Retrospectivos , Razão Sinal-Ruído , Tomografia Computadorizada por Raios X
8.
Eur Radiol ; 31(2): 824-833, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32845387

RESUMO

OBJECTIVES: To compare the diagnostic performances of first and second portal venous phases (PVP1 and PVP2) in revealing washout and capsule appearance for non-invasive HCC diagnoses in gadoxetic acid-enhanced MRI (Gd-EOB-MRI). METHODS: This retrospective study included 123 at-risk patients with 160 hepatic observations (HCCs, n = 116; non-HCC malignancies, n = 18; benign, n = 26) showing arterial phase hyper-enhancement (APHE) ≥ 1 cm at Gd-EOB-MRI. The mean time intervals from gadoxetic acid injection to PVP1 and PVP2 acquisitions were 53 ± 2 s and 73 ± 3 s, respectively. After evaluating image findings independently, imaging findings and diagnoses were finalized by a consensus of two radiologists using either PVP1 or PVP2 image sets according to the LI-RADS v2018 or EASL criteria. Sensitivity, specificity, and accuracy were compared. RESULTS: Among HCCs, more washout and enhancing capsule were observed in PVP2 (83.6% and 27.6%) than in PVP1 (50.9% and 19.8%) (p < 0.001, both). The PVP2 set presented significantly higher sensitivity (83.6% vs. 53.5%, LI-RADS; 82.8% vs. 50.0%, EASL; p < 0.001, both) and accuracy (0.88 vs. 0.73, LI-RADS; 0.88 vs. 0.72, EASL; p < 0.001, both) than the PVP1 set without significant specificity loss (93.2% vs. 93.2%, by LI-RADS or EASL; p = 0.32, both). None of the non-HCC malignancy was non-invasively diagnosed as HCC in both PVP image sets. CONCLUSION: Late acquisition of PVP detected washout and enhancing capsule of HCC more sensitively than early acquisition, enabling accurate diagnoses of HCC, according to LI-RADS or EASL criteria. KEY POINTS: • Among HCCs, more washout and enhancing capsules were observed in PVP2 than PVP1, quantitatively and qualitatively. • The portal venous phase acquired at around 70 s after contrast media administration (PVP2) provided significantly higher sensitivity and AUC value than PVP1 by using LI-RADS v2018 or EASL criteria. • More HCCs were categorized as LR-5 in PVP2 than in PVP1 images, and the specificity of PVP2 (93.5%) was comparable with PVP1 (93.5%).


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Carcinoma Hepatocelular/diagnóstico por imagem , Meios de Contraste , Gadolínio DTPA , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Imageamento por Ressonância Magnética , Estudos Retrospectivos , Sensibilidade e Especificidade
9.
Abdom Radiol (NY) ; 46(4): 1468-1477, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-32986174

RESUMO

PURPOSE: To determine whether reduced field-of-view (rFOV) DWI sequences can improve image quality and diagnostic performance compared with conventional full FOV (fFOV) DWI in the prediction of complete response (CR) to neoadjuvant chemoradiotherapy (CRT) in patients with locally advanced rectal cancers. METHODS: Between September 2015 and December 2017, seventy-three patients with locally advanced rectal cancers (≥ T3 or lymph node positive) who underwent CRT and subsequent surgery were included in this retrospective study. All patients had tumor located no more than 10 cm from the anal verge, and underwent rectal MRI including fFOV b-1000 DWI and rFOV b-1000 DWI at 3 T before and after CRT. Image quality and diagnostic performance in predicting CR were compared between rFOV DWI and fFOV DWI sets by two reviewers. RESULTS: Based on a 12-point scale, rFOV DWI provided better image quality scores than fFOV DWI (9.1 ± 1.7 vs. 8.4 ± 1.0, respectively, P < 0.001). Diagnostic accuracy (Az) in evaluating CR was better with the rFOV DWI set than with the fFOV DWI set for both reviewers: reviewer 1, 0.78 vs. 0.57 (P = .004); reviewer 2, 0.72 vs. 0.61 (P = .031). CONCLUSION: rFOV DWI of rectal cancer can provide better overall image quality, and its addition to conventional rectal MRI may provide better diagnostic accuracy than fFOV DWI in the evaluation of CR to neoadjuvant CRT in patients with locally advanced rectal cancer.


Assuntos
Terapia Neoadjuvante , Neoplasias Retais , Imagem de Difusão por Ressonância Magnética , Humanos , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/terapia , Reto , Estudos Retrospectivos , Resultado do Tratamento
10.
Liver Cancer ; 9(3): 293-307, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32647632

RESUMO

INTRODUCTION: The detection of portal vein tumor thrombosis (PVTT) in patients with hepatocellular carcinoma (HCC) meeting the Milan criteria is of critical importance as PVTT is known to be a contraindication to transplantation and an indicator of a dismal prognosis. OBJECTIVE: To determine which modality may best detect PVTT, we compared the diagnostic performance of gadoxetic acid-enhanced MRI (GA-MRI) and contrast-enhanced CT (CECT) in HCC patients meeting the Milan criteria. METHODS: We retrospectively enrolled 310 patients with HCCs meeting the Milan criteria who underwent both GA-MRI and CECT between June 2007 and May 2017. Among them, 44 patients were demonstrated to have PVTT while 266 patients had no PVTT. Two radiologists then assessed GA-MRI and CECT images for the presence of PVTT on a 5-point scale as well as vessel expansion, continuity with tumors, and enhancement on both modalities, as well as T2 hyperintensity and diffusion restriction on GA-MRI. The McNemar test was used to compare sensitivity and specificity of GA-MRI and CECT for the detection of PVTT, and Fisher's exact test was used to compare their imaging features. RESULTS: GA-MRI showed higher sensitivity values than CECT in detecting PVTT (reviewer 1, 93.2% [41/44] vs. 77.3% [34/44]; reviewer 2, 88.6% [39/44] vs. 70.5% [31/44]) (both p = 0.039). Specificity of GA-MRI and CECT demonstrated no difference (reviewer 1, 95.5% [254/266] vs. 95.1% [253/266]; reviewer 2, 97.0% [258/266] vs. 97.4% [259/266]) (both p > 0.999). Continuity with tumors and enhancement were more frequently observed on GA-MRI than on CECT (p < 0.050, both reviewers). CONCLUSION: GA-MRI detected PVTT more often than CECT in HCC patients meeting the Milan criteria and better depicted PVTT in continuity with tumors and those showing enhancement than CECT.

11.
PLoS One ; 15(1): e0227492, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31929591

RESUMO

OBJECTIVE: To evaluate the role of computerized 3D CT texture analysis of the pancreas as quantitative parameters for assessing diabetes. METHODS: Among 2,493 patients with diabetes, 39 with type 2 diabetes (T2D) and 12 with type 1 diabetes (T1D) who underwent CT using two selected CT scanners, were enrolled. We compared these patients with age-, body mass index- (BMI), and CT scanner-matched normal subjects. Computerized texture analysis for entire pancreas was performed by extracting 17 variable features. A multivariate logistic regression analysis was performed to identify the predictive factors for diabetes. A receiver operator characteristic (ROC) curve was constructed to determine the optimal cut off values for statistically significant variables. RESULTS: In diabetes, mean attenuation, standard deviation, variance, entropy, homogeneity, surface area, sphericity, discrete compactness, gray-level co-occurrence matrix (GLCM) contrast, and GLCM entropy showed significant differences (P < .05). Multivariate analysis revealed that a higher variance (adjusted OR, 1.002; P = .005), sphericity (adjusted OR, 1.649×104; P = .048), GLCM entropy (adjusted OR, 1.057×105; P = .032), and lower GLCM contrast (adjusted OR, 0.997; P < .001) were significant variables. The mean AUCs for each feature were 0.654, 0.689, 0.620, and 0.613, respectively (P < .05). In subgroup analysis, only larger surface area (adjusted OR, 1.000; P = .025) was a significant predictor for T2D. CONCLUSIONS: Computerized 3D CT texture analysis of the pancreas could be helpful for predicting diabetes. A higher variance, sphericity, GLCM entropy, and a lower GLCM contrast were the significant predictors for diabetes.


Assuntos
Diabetes Mellitus Tipo 1/patologia , Diabetes Mellitus Tipo 2/patologia , Pâncreas/diagnóstico por imagem , Adulto , Idoso , Área Sob a Curva , Índice de Massa Corporal , Entropia , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Curva ROC , Tomografia Computadorizada por Raios X
12.
Ultrasonography ; 39(1): 85-93, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31759383

RESUMO

PURPOSE: The purpose of this study was to compare the sensitivity of MicroFlow Imaging (MFI) with that of color and power Doppler imaging (CDI and PDI, respectively) in detecting the vascularity of hepatocellular carcinomas (HCCs). METHODS: This prospective study enrolled 51 patients diagnosed with HCC between August 2018 and December 2018. CDI, PDI, MFI, and contrast-enhanced ultrasound (CEUS) were performed. Two radiologists evaluated the presence and pattern of tumoral vascularity on CDI, PDI, and MFI. Vascular presence was graded on a 5-point scale (0, absent; 4, >50% of the tumor). The vascular pattern was chosen from following categories: basket, vessels in tumor, spot, detouring, mixed, or others. Two additional radiologists assessed CEUS images for the presence and pattern of tumoral vascularity, which served as the reference standard. If the tumoral vascular pattern on each examination matched that of the CEUS images, the Wilcoxon test and McNemar test, respectively, were used to compare the sensitivity for detecting tumoral vascularity between MFI and CDI, and between MFI and PDI. Logistic regression analysis was performed to identify factors associated with MFI detectability of tumoral vascularity. RESULTS: CEUS demonstrated tumoral vascularity in 98.0% (50 of 51) of patients. MFI (58.0%, 29 of 50) demonstrated a higher sensitivity than CDI (14.0%, 7 of 50) or PDI (14.0%, 7 of 50) (P<0.001 for both) in detecting tumoral vascularity, provided that the vascular pattern was correctly depicted. Only tumor depth was associated with the MFI detectability of tumoral vascularity. CONCLUSION: The sensitivity of MFI was higher than that of CDI or PDI in detecting the vascularity of HCCs when the vascular pattern was considered. MFI better detected the vascularity of shallow tumors.

13.
Korean J Radiol ; 19(5): 930-937, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30174483

RESUMO

Objective: The purpose of this study was to asses the CT findings and clinical features differentiating malignant from benign focal splenic lesions. Materials and Methods: Among 673 patients with splenectomy, we included 114 patients with pathologically confirmed focal splenic lesions (malignant = 66, benign = 48). Two radiologists retrospectively assessed CT findings including: size, number, solid component, margin, wall, calcification, contrast-enhancement, lymph node (LN) enlargement and possible malignancy. We assessed clinical features including age, sex, underlying malignancy, fever, and leukocytosis. Multivariate logistic regression analysis was performed to identify significant predictors of malignant lesion. We used receiver operating curve analysis for determination of diagnostic performance. Results: Common findings of malignant lesions include enhanced, mainly solid, ill-defined margin, absence of splenomegaly, absence of the wall, absence of calcification, LN enlargement, and presence of underlying malignancy (p < 0.05). Among them, mainly solid features (odds ratio [OR], 39.098, p = 0.007), LN enlargement (OR, 6.326, p = 0.005), and presence of underlying malignancy (OR, 8.615, p = 0.001) were significant predictors of malignancy. The mean size of benign splenic lesions (5.8 ± 3.3 cm) was larger than that of malignant splenic lesions (4.0 ± 3.4 cm). Diagnostic performance of CT findings by two reviewers using receiver operating characteristic curve analysis for differentiation of malignant lesions was 0.856 and 0.893, respectively. Conclusion: Solid nature of the splenic mass on CT images, LN enlargement, and presence of underlying malignancy are significant predictors of malignant splenic lesion.


Assuntos
Esplenopatias/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Área Sob a Curva , Diagnóstico Diferencial , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Modelos Logísticos , Linfonodos/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Razão de Chances , Curva ROC , Estudos Retrospectivos , Esplenectomia , Esplenopatias/diagnóstico por imagem , Esplenopatias/patologia , Neoplasias Esplênicas/diagnóstico , Neoplasias Esplênicas/diagnóstico por imagem , Neoplasias Esplênicas/patologia , Adulto Jovem
14.
J Magn Reson Imaging ; 45(6): 1627-1636, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-27859840

RESUMO

PURPOSE: To demonstrate the negative relationship between liver stiffness (LS) values measured at preoperative magnetic resonance elastography (MRE) and the regeneration capacity of the remnant liver after major hepatectomy, in patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Thirty-eight patients with HCC (mean age, 57.1) who had undergone liver computed tomography (CT) and 1.5T MRE prior to right hepatectomy were included in this retrospective study. CT volumetric analysis of total functional liver (calculated by subtracting tumor volume from total liver volume), future liver remnant (FLR), and postoperative liver remnant (LR) were performed using a semiautomatic analysis program. The regeneration index was expressed as [(VLR -VFLR )/VFLR ] × 100, where VLR is the volume of the liver remnant and VFLR is the volume of the FLR. The relationship between degree of LS measured at MRE and the regeneration index was assessed using the Spearman correlation test. RESULTS: Average LS value at MRE increased along with hepatic fibrosis (HF) stage (r = 0.604, P < 0.001). At MRE, a cutoff value greater than 2.46 kPa yielded 90.0% sensitivity and 100% specificity in identifying HF stage 2 or greater (area under the curve [AUC], 0.95). Mean VFLR and VLR were 477.1 ± 147.5 mL and 911.9 ± 188.8 mL, respectively. The regeneration index of the liver remnant was 102.1 ± 58.2%. LS values at MRE and calculated regeneration index after right hepatectomy showed moderate negative correlation (r = -0.361, P = 0.026). CONCLUSION: LS values measured at MRE may serve as a postoperative predictor of liver regeneration in patients with liver cirrhosis and HCC. LEVEL OF EVIDENCE: 4 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1627-1636.


Assuntos
Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/cirurgia , Técnicas de Imagem por Elasticidade/métodos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/cirurgia , Regeneração Hepática , Imageamento por Ressonância Magnética/métodos , Carcinoma Hepatocelular/complicações , Feminino , Hepatectomia , Humanos , Cirrose Hepática/diagnóstico por imagem , Cirrose Hepática/etiologia , Cirrose Hepática/cirurgia , Neoplasias Hepáticas/complicações , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios/métodos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Resultado do Tratamento
15.
Rev Sci Instrum ; 85(11): 11D862, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25430275

RESUMO

A solid particle injection system is developed for KSTAR. The system has a compact size, compatibility with a strong magnetic field and high vacuum environment, and the capability to inject a small amount of solid particles with a narrow injection angle. The target flight-distance of 10 cm has been achieved with a particle loss rate of less than 10%. Solid impurity particles such as tungsten and carbon will be injected by this system at the midplane in KSTAR. The impurity transport feature will be studied with a soft X-ray array, a vacuum ultra-violet diagnostic, and Stand Alone Non-Corona code.

16.
Rev Sci Instrum ; 85(11): 11E827, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25430392

RESUMO

Four-array system of soft X-ray diagnostics was installed on KSTAR tokamak. Each array has 32 viewing chords of two photo-diode array detectors with spatial resolution of 2 cm. To estimate signals from the soft X-ray radiation power, typical ne, Te, and argon impurity line radiation profiles in KSTAR are chosen. The photo-diodes were absolutely calibrated as a function of the incident photon energy in 2-40 keV range with a portable X-ray tube. Two-dimensional Te image properties by multi-energy method were simulated and visualized with six combinations of beryllium filter sets within the dynamic range of signal ratio.

17.
Rev Sci Instrum ; 83(10): 10E512, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23127019

RESUMO

A multi-purpose soft x-ray array diagnostic system was developed for measuring two-dimensional x-ray emissivity profile, electron temperature, Ar impurity transport, and total radiation power. A remotely controlled filter wheel was designed with three different choices of filters. The electron temperature profile can be determined from the ratio of two channels having different thickness of Be layer, and the Ar impurity concentration transport can be determined from a pair of Ar Ross filters (CaF(2) and NaCl thin films). Without any filters, this diagnostic system can also be used as a bolometer.

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