Measurements of Hepatic Metastasis on MR Imaging:: Assessment of Interobserver and Intersequence Variability.

RATIONALE AND OBJECTIVES: The purpose of the study was to investigate interobserver and intersequence variability in the measurement of hepatic metastasis on magnetic resonance imaging (MRI). MATERIALS AND METHODS: This retrospective study was conducted with an institutional review board-approved waiver of informed consent and was in compliance with the Health Insurance Portability and Accountability Act. We searched medical records at our institution for patients with histologically proven metastases to the liver who had undergone MRI from January 2008 to June 2010. We identified 20 patients with 30 measurable liver lesions. The liver lesions were measured on five different MRI sequences. A presenter radiologist selected and localized all metastatic lesions considered to be measurable according to the Response Evaluation Criteria in Solid Tumors, and these lesions were measured (Eisenhauer et al., 2009) by three radiologists independently. We calculated lesion-wise intraclass correlation coefficients (ICCs) to estimate interobserver and intersequence agreement in lesion diameter measurement. A Bland-Altman plot was used to estimate the limits of agreement between radiologists and MRI sequences. RESULTS: There were 30 metastases, and almost all of which had regular and well-defined margins. Interobserver ICCs were greater than 0.95 for different MRI sequences except for the measurements in apparent diffusion coefficient images. Intersequence ICCs were greater than 0.92. Bland-Altman plots between physicians confirmed that reader measurements were closely tied together, with small differences in means. CONCLUSIONS: MRI can reproducibly measure hepatic metastatic lesions without significant variability among interpreting radiologists or among MRI sequences, and is thus a reliable method for assessing the size of hepatic metastasis.

BMI-based radiation dose reduction in CT colonography.

RATIONALE AND OBJECTIVES: There is potential for x-ray dose reduction in computed tomography colonography (CTC) relative to body mass index (BMI). We evaluated the association between BMI and three-dimensional (3D) CTC image quality to assess the potential utility of BMI as the basis for radiation dose reduction in CTC. MATERIALS AND METHODS: Ninety-six consecutive patients underwent CTC and were randomized for scanning at 15 or 30 mAs. Extremely obese patients (BMI > 50) were excluded. Each patient was scanned supine and prone on a multidetector CT scanner. Postprocessing CTC visualization was performed on a dedicated workstation. Three independent observers assessed 3D image quality using a four-point scale. Image noise was measured in both the abdomen and pelvis. The association between BMI and image noise was examined using random-effects linear regression models. Logistic regression was used to examine the relationship between BMI, mAs, and conspicuity scores. RESULTS: Statistically significant differences in image noise were observed between 15 and 30 mAs in both the abdomen and pelvis, and the difference was greater with increasing BMI. A positive relationship was detected between BMI and noise in the abdomen (P < .001) and pelvis (P < .001). Inverse correlation was identified between BMI and conspicuity scores in the abdomen (P = .01) and pelvis (P < .001). Overall conspicuity scores were reduced for both 15 and 30 mAs groups as BMI increased. CONCLUSION: The radiation dose for CTC can be reduced by 40% and 70% below commonly employed doses for overweight and normal BMI patients, respectively, by using a BMI-adjusted dose reduction approach. Conspicuity scores dropped in obese patients with reduced dose suggesting that standard accepted doses should be utilized in that group.

Single voxel magnetic resonance spectroscopy at 3 Tesla in a memory disorders clinic: early right hippocampal NAA/Cr loss in mildly impaired subjects.

In this study, we use magnetic resonance spectroscopy (MRS) at 3 Tesla to measure N-acetyl aspartate (NAA), myo-inositol (mI) and choline (Cho) to creatine (Cr) ratios in R (right) and L (left) hippocampi (H) in 8 mildly memory impaired (MMI), 6 probable Alzheimer's Disease (PRAD), and 17 control subjects. NAA/Cr was significantly reduced in the RH in the MMI group and bilaterally in the PRAD group vs. controls. No other metabolite differences were noted between the three groups. Five MMI subjects have converted to PRAD in follow-up. These findings suggest that RH NAA/Cr ratios measured at 3 Tesla may be a sensitive marker of future progression to dementia in a clinically defined population with isolated memory complaints.

The effects of long chain-length n-alcohols on the firing frequency of dopaminergic neurons of the ventral tegmental area.

The dopaminergic neurons of the ventral tegmental area (DA VTA neurons) have been implicated in the reinforcing properties of drugs of abuse, including ethanol (ethyl alcohol). Ethanol increases the spontaneous firing frequency of DA VTA neurons in vitro, in both brain slices and acutely dissociated neurons, and also in vivo. In many systems, longer n-alkyl alcohols have a more potent effect than ethanol, and the potency is a function of the number of carbons in the alkyl chain. We studied n-alcohols of chain length 1 (methanol) to 5 (pentanol) on the firing rate of DA VTA neurons in brain slice preparations. All of the alcohols studied produced increases in the spontaneous firing frequency in DA VTA neurons; as the chain length increased, lower concentrations of the alcohols were needed to produce the same percentage increase in firing. With very high concentrations of all the alcohols except methanol, we observed apparent depolarization block of firing. In addition, trichloroethanol (TCE), the active metabolite of chloral hydrate, increased the firing frequency of DA VTA neurons, and the EC(40) (concentration to produce a 40% increase in firing rate) of TCE was below that of ethanol. These studies indicate that excitation of VTA dopamine neurons by n-alcohols is related to the chain length of the carbons. This is likely to be a characteristic of the ethanol-sensitive element of DA VTA neurons and may be useful in identifying the element of the membrane that is responsible for ethanol-induced excitation.