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Archive for June, 2011

Compared to non-seniors, extracolonic findings were more rapid in seniors, despite there was no statistical deviation in rate of recommendation for additional imaging amid both the groups.

 

The medical research study was conducted by Michael Macari, MD, Gregory Nevsky, MD, John Bonavita, MD, Danny C. Kim, MD, Alec J. Megibow, MD, MPH and James S. Babb, PhD from the Department of Radiology, New York University School of Medicine, New York, NY.

The study is available in online journal of Radiological Society of North America, and the research objective was to retrospectively assess the rate of recommendations for additional imaging for significant extracolonic findings and prevalence of polyps amongst group of senior citizens (above 65 years of age), and non-seniors (below 65 years of age) experiencing low-dose computed tomography colonography.

HIPAA compliant, and approved by institutional review board, the study was comprised of 454 patients, which had 204 non-seniors, and 250 seniors – they underwent CT colonography at outpatient clinic. The cases were prospectively indicated by abdominal radiologist, skilled in CT colonography – the reports were examined for determination of frequency of polyps, extracolonic findings and recommendation for additional imaging (RAI).

For the non-senior group, the percentage for at least one reported polyp was 14.2%, and for seniors – it was 13.2%, and not significantly different. The percentage level for at least one extracolonic with non-seniors was 55.4%, where as for seniors – it was 74.0%. recommendation for additional imaging of 4.4% for non-seniors and 6.0% for seniors was not significantly different.

Conclusion: Compared to non-seniors, extracolonic findings were more rapid in seniors, despite there was no statistical deviation in rate of recommendation for additional imaging amid both the groups.

Magnetic resonance imaging and computed tomography are in the same manner appropriate for staging and detection of pancreatic carcinoma.

 

The medical research study was conducted by Claus Koelblinger, MD, Ahmed Ba-Ssalamah, MD, Peter Goetzinger, MD, Stefan Puchner, MD, Michael Weber, PhD, Klaus Sahora, MD, Martina Scharitzer, MD, Christina Plank, MD and Wolfgang Schima, MD, MSc from the Departments of Radiology and Surgery, Medical University of Vienna; and Department of Radiology, KH Goettlicher Heiland and Herz-Jesu Krankenhaus, Vienna, Austria.

The study is available in online journal of Radiological Society of North America, and the research objective was to evaluate the analytical performance of  gadobenate dimeglumine-enhanced 3.0-T MR imaging  with that of multiphasic 64–detector row computed tomography for pancreatic carcinoma patients.

Approved by institutional review board and with written consent from patients, about 89 patients were selected for the study, inclusive of women (mean age of 65.6 years) and men (mean age of 65.3 years), presented with pancreatic carcinoma, through clinical findings and previous examinations. All underwent MR and multidetector CT imaging.

Two independent readers evaluated the images for characterization of lesions, and to firmly decide on existence of vascular invasion, focal masses, distant metastases, and resectability. Conclusions through biopsy, surgery, endosonography and other follow-up examinations were taken as reference for the study, and statistical analysis were done through McNemar’s test, and logistic regression type.

About the results, 43 patients had adenocarcinoma, and 63 patients showed up with presence of focal pancreatic masses. For the independent reader – 1, the specificities and sensitivities for pancreatic adenocarcinoma were 96% and 98% for computed tomography and MRI. For the reader – 2, the specificities and sensitivities were 96% and 93% for computed tomography, and 96% and 95% for MRI.

Reader-1 for vessel infiltration of 22 patients that went through surgery showed specificities and sensitivities of 98% and 90% respectively for computed tomography, and 96% and 80% for MRI. In case of reader-2, specificity and sensitivity values were 98% and 70% for CT, and 98% and 50% for MRI.

The assessments were correct from both the readers, of resectability in 87% with CT, and 93% with MRI. For nonresectability, it were 75% with CT (reader-1), and 63% (reader-2); with MRI, nonresectability was correctly assessed in 75% cases (reader-1), and 50% cases (reader-2). The differences amid readers and modalities were not statistically significant, by any means.

Conclusion: Magnetic resonance imaging and computed tomography are in the same manner appropriate for staging and detection of pancreatic carcinoma.

MR elastography with liver stiffness measurements is feasible for patients with non-alcoholic fatty liver disease for identification of steatohepatitis, even before the beginning of fibrosis.

 

The medical research study was conducted by Richard L. Ehman, MD, Jun Chen, PhD, Jayant A. Talwalkar, MD, Meng Yin, PhD, Kevin J. Glaser, PhD, and Schuyler O. Sanderson, MD from the Departments of Radiology, Gastroenterology, and Anatomic Pathology, Mayo Clinic, Rochester, MN.

The study is available in online journal of Radiological Society of North America, and the research objective was to examine diagnostic precision of MR Elastography for early identification of Nonalcoholic Steatohepatitis (NASH) in patients with non-alcoholic fatty liver disease (NAFLD).

Approved by institutional review board, and HIPAA compliant, the study included 58 patients presented with non-alcoholic fatty liver disease. Liver stiffness, fat fraction, inflammation grade, and fibrosis stages were evaluated through MR elastography. ROC, T-test and partial correlation analysis were carried out.

For the patients patients with inflammation, but no fibrosis – the mean hepatic stiffness was higher than that of patients with simple steatosis. Patients with hepatic fibrosis, the mean hepatic stiffness was higher than that of patients with inflammation, but no fibrosis. In contrast to simple steatosis, liver stiffness had high precision for careful judgment of patients with nonalcoholic steatohepatitis, with a sensitivity of 94%, through the point of entry of 2.74 kPa.

Conclusion: MR elastography with liver stiffness measurements is feasible for patients with non-alcoholic fatty liver disease for identification of steatohepatitis, even before the beginning of fibrosis. Patients with non-alcoholic fatty liver disease, with inflammation, and no fibrosis have greater hepatic stiffness than others with simple steatosis.

Mutually exclusive MR imaging criteria for diagnosing hepatocellular carcinoma in 1–2-cm nodules discovered at surveillance ultrasonography can enhance sensitivity, in comparison to AASLD.

 

The medical research study was conducted by Tae Kyoung Kim, MD, Kyoung Ho Lee, MD, Hyun–Jung Jang, MD, Masoom A. Haider, MD, Lindsay M. Jacks, MSc, Ravi J. Menezes, PhD, Seong Ho Park, MD, Leyla Yazdi, MD, Morris Sherman, MD and Korosh Khalili, MD from the Departments of Medical Imaging, Biostatistics, and Medicine, University of Toronto, Toronto General Hospital, ON, Canada; Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Korea; and Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

The study is available in online journal of Radiological Society of North America, and the research objective was to retrospectively recognize out MRI findings related with hepatocellular carcinoma (HCC) in 1–2-cm nodules discovered at close ultrasound observation, and to put forward newer MRI criteria.

Approved by institutional board and written consent from patients, 145 patients presented with newly detected 1-2 cm nodules went through gadobenate dimeglumine-enhanced MR imaging. After exclusion of unconfirmed nodules and hemangiomas, about 96 patients were continued through, with 116 nodules, inclusive of 73 benign nodules and 43 hepatocellular carcinomas. Signal intensity at every sequence were assessed by through MRI findings. Through with results of univariate and multivariate regression models, various analytical criteria were elaborated utilizing data set of MRI findings, which were then equated with practice guidelines of American Association for the Study of Liver Diseases (AASLD).

About the results, univariate analysis divulged subsequent findings related with hepatocellular carcinoma: arterial phase hyperintensity, hyperintense signal changes on T2-weighted images, portal venous/delayed hypointensity, and hepatobiliary-phase. In multivariate regression, portal/delayed phase hypointensity and arterial phase hyperintensity were related with hepatocellular carcinoma. Of the advanced criteria, with nodules befitting AASLD, or nodules with more than 3 findings were regarded as with sound judgment, demonstrating enhanced sensitivity, and equivalent specificity.

Conclusion: Mutually exclusive MRI criteria for analyzing hepatocellular carcinoma in 1-2 cm nodules recognized at close ultrasound observation can enhance sensitivity, in contrast to that with proposed AASLD practice guidelines. Further study is required to substantiate the denoting concept in this research study.

Three-dimensional late gadolinium enhancement MRI is feasible for assessment of transmurality and scar tissue mass in patients with acute or chronic myocardial infarction at considerably reduced acquisition times.

 

The medical research study was conducted by Robert Manka, MD, Robert Goetti, MD, Sebastian Kozerke, PhD, Olivio F. Donati, MD, Daniel Sürder, MD, Paul Stolzmann, MD, Philipp A. Kaufmann, MD, Thomas F. Lüscher, MD, Roberto Corti, MD from Department of Diagnostic Radiology, Department of Cardiac Imaging, and Cardiology Clinic, University Hospital Zurich; and Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland.

The study is available in online journal of Radiological Society of North America, and the research objective was to evaluate late gadolinium enhancement (LGE), single–breath-hold three-dimensional inversion recovery MRI sequence for myocardial scar quantification and transmurality of myocardial infarction, in contrast to clinically recognized 2D sequence.

Established by institutional review board and written consent from patients, the study was comprised of 90 patients, with mean age of 54.4 years, presented with acute, sub-acute/chronic myocardial infarction cases. 1.5T MRI was utilized for to image them; the angular resolution was similar for 2D and 3D images. Bland-Altman plot and Pearson’s correlation coefficient were put to use for quantitative analogy of myocardial/scar mass, scar transmurality on five-point scale.

No significant deviation could be established amid collection of data of 2D and 3D, with respect to mean myocardial and scar tissue mass, and the mean deviation were assessed by. Except for acquisition time which was considerably shorter for 3D dataset, the compatibility of observations pertain to scar transmurality was good.

Conclusion: Three-dimensional late gadolinium enhancement MRI makes possible the assessment of transmurality and scar tissue mass in patients with acute or chronic myocardial infarction, at considerably reduced acquisition times, in contrast with 2D LGE magnetic resonance imaging.

Plateau curve enhancement and non-mass lesions are prevalent MRI findings of pure ductal carcinoma in situ.

The lesions with mass visibility on MRI findings have more suspicious kinetic features, than non-mass lesions.

 

The medical research study was conducted by Jeong-Ah Kim, Eun Ju Son, Ji Hyun Youk, Eun-Kyung Kim, Min Jung Kim, Jin Young Kwak and Joon Jeong from Department of Radiology and Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.

The study is available in online journal of American Roentgen Ray Society, and the research objective were to examine the kinetic and morphologic features of pure ductal carcinoma in situ, and MR images, and to equate the kinetic characteristics in relation to mammographic/sonographic findings, MRI lesion type and histopathologic factors.

About 67 patients presented with histologically demonstrated pure ductal carcinoma in situ were picked up for the study. Breast Imaging-Reporting and Data System (BIRADS) was utilized to analyze MRI findings, without pathological data. Quantitative variables of enhancement pattern were calculated for lesions, along with assessment of histological factors of hormone receptor and c-erbB-2 expression status, nuclear grade etc.

Independent assessments were made for sonographic and mammographic findings, without facts about MRI, and kinetic features were equated, in relation to MRI lesion type, mammographic/sonographic finding and histopathologic factors.

About the results, the prevalent morphological appearance was a non mass lesion with diverse enhancement, where the pure ductal carcinoma in situ lesions displayed inconsistent enhancement patterns composed of plateau, persistent and washout curves. Other than correlation of MRI lesion type with mean enhancement slope, time to peak enhancement and same of sonographic findings with time to peak enhancement, there was were no statistically significant relationship amid histopathologic factors/mammographic finding and kinetic features.

Conclusion: Plateau curve enhancement and non-mass lesions were prevalent MRI findings of pure ductal carcinoma in situ. In contrast to non-mass lesions, the lesions with mass appearance at MRI findings had more leery kinetic features.

The levonorgestrel-releasing intrauterine system/mirena is considerably less perceptible than copper intrauterine devices on 2D imaging.

3D ultrasound improves the discernibility of both the types of intrauterine devices.

 

The medical research study was conducted by Elysia Moschos and Diane M. Twickler from Department of Obstetrics and Gynecology, Division of Gynecology, and Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX.

The study is available in online journal of American Roentgen Ray Society, and the research objective was to estimate discernibility and position evaluation of intrauterine devices (IUD) on 2D ultrasound and 3D ultrasound in patients that are not pregnant.

Previous ultrasound database from July 2008-2009 were assessed for identification of patients with intrauterine devices, and for position and type of it, with current symptoms. Depending on 7 point grading scale, the discernibility of intrauterine device on transverse and 2D sagittal planes, and 3D coronal reconstructed view was recorded, and then the data was analyzed through Pearson’s chi-square and Student’s t test.

Out of 269 patients with intrauterine device that had undergone ultrasound at the study period – 180 patients showed up with copper IUD, 59 with levonorgestrel intrauterine system (Mirena), and 3 with Lippes loop. 27 IUDs could not be established, and were to be barred out.

The discernibility score for copper IUDs varied considerably from mirena/levonorgestrel-releasing intrauterine system on 2D ultrasound, of 239 IUDs that were being recognized out.

The deviation in the discernibility score for copper IUDs in contrast to mirena on 3D ultrasound was to a limited extent substantial. Other than 74% cases of IUDs within endometrial cavity, other IUDs were malpositioned, where 3 IUDs could not be established with. Many cases were being reported of pain, missing strings, bleeding (due to malposition) etc.

Conclusion: The levonorgestrel-releasing intrauterine system/mirena is considerably less perceptible than copper intrauterine devices on 2D imaging. 3D ultrasound improves the discernibility of both the types of intrauterine devices.

The use of digitized priors enhances full-field digital mammography (FFDM) interpretation time: Study

 

The medical research study was conducted by Akshay S. Garg, Jocelyn A. Rapelyea, Lauren R. Rechtman, Jessica Torrente, Rebecca B. Bittner, Caitrín M. Coffey and Rachel F. Brem from Department of Radiology, Breast Imaging and Interventional Center, The George Washington University Medical Center, Washington, DC.

The study is available in online journal of American Roentgen Ray Society, and the research objective was to quantitatively equate interpretation time of screening full field digital mammography images through prior film-based studies (mammogram) for analogy, in contrast to prior digitized analog mammogram.

Four radiologists translated images through about 100 full field digital mammography studies, all the images had comparison analog mammograms accumulated one year before and so, which were digitized through 43 micrometer film digitizer.

At first, the full field digital mammography images were translated through digitized prior mammogram on two – PACS and 5-megapixel medical monitors. After one month, the 100 full field digital mammography studies were translated through original analog mammograms, on an alternator at 90° to medical monitors utilized to interpret screening FFDMs – the translation time and results were documented, equated and assessed for statistical deviation.

The mean reading time for full field digital mammography studies with prior digitized analog mammography was considerably shorter, in comparison to that of interpretation with prior analog. The recorded time deviation amid digitized analog in contrast to analog varied from 11.31-74.18 seconds. The reading times of all the readers varied from 17.32-185.94 seconds with an average of 58.56 seconds through analog film prior mammograms.

The readings varied from 11.32-109.11 seconds with an average of 39.76 seconds, when used digitized analog prior mammograms. The mean deviation in reading time was 18.80 seconds, and demonstrated 32% increase in interpretation speed on utilizing prior digitized analog contrast to analog prior.

Conclusion: Full-field digital mammographic interpretation with prior digitized analog mammography showed mean improvement (32.1%) than interpretation with prior analog. It will facilitate for more full field digital mammography to be translated over, in same fraction of time, if digitized prior analog mammograms are utilized.

Ultrasound spleen volume does not reflect function, but increased volume shows mutual relationship with glomerular filtration rate.

Sonographic biliary defects can form early in life, though staying clinically silent.

 

The medical research study was conducted by M. Beth McCarville, Zhaoyu Luo, Xiangke Huang, Renee C. Rees, Zora R. Rogers, Scott T. Miller, Bruce Thompson, Ram Kalpatthi, Winfred C. Wang from Department of Radiological Sciences, St. Jude Children’s Research Hospital, Memphis TN; Clinical Trials & Surveys Corporation, Baltimore, MD; Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX; Department of Hematology, State University of New York–Downstate Medical Center/Kings County Hospital Center, Brooklyn, NY; Children’s Mercy Hospitals and Clinics, Kansas City, MO; Department of Hematology, St. Jude Children’s Research Hospital, Memphis, TN.

The study is available in online journal of American Roentgen Ray Society, and the research objective was to carry out and assess baseline abdominal ultrasonography in infant babies with sickle cell anemia (a grave hereditary form of anemia) that took part in BABY HUG multi-institutional randomized controlled trial (RCT), for to measure the capacity and effectiveness of hydroxyurea therapy, and to evaluate the potential association amid results of ultrasound and clinical/laboratory data.

Approved by institutional review board, and written consent from kins of patients, about 87 boys and 116 girls presented with sickle cell anemia experienced abdominal sonography at varied medical institutions. Centralized examination review from a radiologist was carried through for measurement and evaluation of kidneys, ductus choledochus/common bile duct, spleen and gallbladder. Baseline physical assessment of spleen size, serum alanine aminotransferase (ALT), bilirubin levels, 99mTc-sulfurcolloid scan (liver/spleen), and glomerular filtration rate (GFR) were acquired by.

To equate sonographic findings and issued results in clinical/lab findings and controlled group – variance analysis and student examinations were carried out.

Of the result, the mean spleen volume was found considerably larger than issued control values. No mutual relationship could be established amid spleen volume and activity evaluated by liver-spleen scan. The mean glomerular filtration rate increased, in comparison to that of control glomerular filtration rate. The renal volumes were considerably larger than control volumes, and had positive mutual relationship with glomerular filtration rate. About 5% of patients showed up with gallbladder/biliary tract abnormalities, though there was no mutual relationship amid laboratory results and biliary sonographic discoveries.

Conclusion: In infant babies with sickle cell anemia, ultrasound spleen volume does not bring about activity, but increased volume shows mutual relationship with glomerular filtration rate, and is coherent with hyperfiltration. Sonographic biliary defects can form early in life, though staying clinically silent.

The decreased trend in fluoroscopy time has mutual relationship with documentation of fluoroscopy time – is a substitutive indicator of radiation dosage.

Fluoroscopy time documentation in the report culminates to decreased fluoroscopy time.

 

The medical research study was conducted by Stephen Darling, Marla Sammer, Teresa Chapman and Marguerite T. Parisi from the Departments of Radiology (University of Washington and Seattle Children’s Hospital), Seattle, WA.

The study is available in online journal of American Roentgen Ray Society. Fluoroscopy time is the pointer of radiation usage in fluoroscopy, and the research objective was to evaluate mean fluoroscopy time of examinations with recorded fluoroscopy time in the report, to mean time without documentation, on voiding cystourethrography/micturating cystourethrogram studies.

Database records from June 2002-March 2009 were tracked down from radiology information system, for voiding cystourethrography examinations with documented fluoroscopy time. The radiology report were even recognized out that had recorded fluoroscopy time for examinations. Mean fluoroscopy times were calculated for subsequent groups, viz. voiding cystourethrography examinations, recorded examinations without and with fluoroscopy time.

About 10,594 voiding cystourethrography examinations were being carried out in the span of 7-year study period. The mean fluoroscopy time was 47 seconds for all the examinations, of which 32 seconds for examinations with recorded fluoroscopy time, and 50 seconds for examinations without reported fluoroscopy time. The statistical significant deviation was found amid examinations with and without recorded fluoroscopy time by radiologists. Mean fluoroscopy time for all the voiding cystourethrography examinations showed decreasing trend, as during 2002-2003, the mean fluoroscopy time was 65 seconds, but during 2008-2009 it decreased down to 29 seconds. The recorded fluoroscopy time over the period from radiologists showed the increasing trend, as from 1% in 2002-2003, it jumped to 82% during 2008-2009.

Conclusion: The decreased trend in fluoroscopy time has mutual relationship with documentation of fluoroscopy time, which is a substitutive indicator of radiation dosage. Part of radiation awareness strategy – fluoroscopy time documentation in the report culminates to decreased fluoroscopy time.