European Radiology
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Enhancement patterns of prostate cancer in dynamic MRI
European Radiology - Tập 13 - Trang 925-930 - 2003
Our objective was to analyze fast-field-echo dynamic subtracted (FFE/DS) MRI data in prostate cancer, in order to recognize enhancement patterns of tumoral tissue in comparison with non-tumoral peripheral prostatic tissue. Eleven consecutive patients with prostate cancer were proposed for radical prostatectomy. Before surgery, all patients underwent endorectal coil MRI examination. In addition to standard sequences, a dynamic study was performed by FFE/DS to evaluate tumoral behavior after Gd-DTPA rapid infusion. Analysis of the imaging was made by the means of the time/signal intensity curve obtained during early contrast medium enhancement, sampling both the abnormal enhancing focal area and the opposite lobe at the level of the main prostatic tissue. A focal area of increased enhancement was observed in the site of the tumor in all cases. The time/intensity curve sampled on this area and compared with the opposite lobe demonstrated a high confidence interval of the difference of the data: mean tumor maximal intensity 1331 (SD 187) vs normal 470 (SD 139) and mean tumor rise time 103 s (SD 30) vs normal 250 (SD 38; p<0.01). In tumoral tissue, the enhancement percentage of signal intensity (SI%=pre-contrast minus post-contrast/pre-contrast ×100) was 316.7%. At FFE/DS, there is a typical behavior of the time/intensity curve of contrast enhancement in prostatic cancer that might be employed in diagnosis of the disease.
Cost-effectiveness of lung MRI in lung cancer screening
European Radiology - Tập 30 Số 3 - Trang 1738-1746 - 2020
Model incorporating multiple diffusion MRI features: development and validation of a radiomics-based model to predict adult-type diffuse gliomas grade Abstract
Objectives
To develop and validate a radiomics-based model (ADGGIP) for predicting adult-type diffuse gliomas (ADG) grade by combining multiple diffusion modalities and clinical and imaging morphologic features.
Methods
In this prospective study, we recruited 103 participants diagnosed with ADG and collected their preoperative conventional MRI and multiple diffusion imaging (diffusion tensor imaging, diffusion kurtosis imaging, neurite orientation dispersion and density imaging, and mean apparent propagator diffusion-MRI) data in our hospital, as well as clinical information. Radiomic features of the diffusion images and clinical information and morphological data from the radiological reports were extracted, and multiple pipelines were used to construct the optimal model. Model validation was performed through a time-independent validation cohort. ROC curves were used to evaluate model performance. The clinical benefit was determined by decision curve analysis.
Results
From June 2018 to May 2021, 72 participants were recruited for the training cohort. Between June 2021 and February 2022, 31 participants were enrolled in the prospective validation cohort. In the training cohort (AUC 0.958), internal validation cohort (0.942), and prospective validation cohort (0.880), ADGGIP had good accuracy in predicting ADG grade. ADGGIP was also significantly better than the single-modality prediction model (AUC 0.860) and clinical imaging morphology model (0.841) (all p < .01) in the prospective validation cohort. When the threshold probability was greater than 5%, ADGGIP provided the greatest net benefit.
Conclusion
ADGGIP, which is based on advanced diffusion modalities, can predict the grade of ADG with high accuracy and robustness and can help improve clinical decision-making.
Clinical relevance statement
Integrated multi-modal predictive modeling is beneficial for early detection and treatment planning of adult-type diffuse gliomas, as well as for investigating the genuine clinical significance of biomarkers.
Key Points
• Integrated model exhibits the highest performance and stability.
• When the threshold is greater than 5%, the integrated model has the greatest net benefit.
• The advanced diffusion models do not demonstrate better performance than the simple technology.
European Radiology -
Correction to: No evidence of improved efficacy of covered stents over uncovered stents in percutaneous palliation of malignant hilar biliary obstruction: results of a prospective randomized trial
European Radiology - Tập 30 - Trang 6965-6965 - 2020
On request from the Editors, the authors would like to clarify the following: the patient cohorts in the publications “No evidence of improved efficacy of covered stents over uncovered stents in percutaneous palliation of malignant hilar biliary obstruction: results of a prospective randomized trial”.
Deep learning nomogram based on Gd-EOB-DTPA MRI for predicting early recurrence in hepatocellular carcinoma after hepatectomy
European Radiology - Tập 33 - Trang 4949-4961 - 2023
The accurate prediction of post-hepatectomy early recurrence in patients with hepatocellular carcinoma (HCC) is crucial for decision-making regarding postoperative adjuvant treatment and monitoring. We aimed to explore the feasibility of deep learning (DL) features derived from gadoxetate disodium (Gd-EOB-DTPA) MRI, qualitative features, and clinical variables for predicting early recurrence. In this bicentric study, 285 patients with HCC who underwent Gd-EOB-DTPA MRI before resection were divided into training (n = 195) and validation (n = 90) sets. DL features were extracted from contrast-enhanced MRI images using VGGNet-19. Three feature selection methods and five classification methods were combined for DL signature construction. Subsequently, an mp-MR DL signature fused with multiphase DL signatures of contrast-enhanced images was constructed. Univariate and multivariate logistic regression analyses were used to identify early recurrence risk factors including mp-MR DL signature, microvascular invasion (MVI), and tumor number. A DL nomogram was built by incorporating deep features and significant clinical variables to achieve early recurrence prediction. MVI (p = 0.039), tumor number (p = 0.001), and mp-MR DL signature (p < 0.001) were independent risk factors for early recurrence. The DL nomogram outperformed the clinical nomogram in the training set (AUC: 0.949 vs. 0.751; p < 0.001) and validation set (AUC: 0.909 vs. 0.715; p = 0.002). Excellent DL nomogram calibration was achieved in both training and validation sets. Decision curve analysis confirmed the clinical usefulness of DL nomogram. The proposed DL nomogram was superior to the clinical nomogram in predicting early recurrence for HCC patients after hepatectomy.
• Deep learning signature based on Gd-EOB-DTPA MRI was the predominant independent predictor of early recurrence for hepatocellular carcinoma (HCC) after hepatectomy.
• Deep learning nomogram based on clinical factors and Gd-EOB-DTPA MRI features is promising for predicting early recurrence of HCC.
• Deep learning nomogram outperformed the conventional clinical nomogram in predicting early recurrence.
A case of missing mitral valve leaflet: radiological detection
European Radiology - Tập 13 Số S6 - Trang L11-L13 - 2003
Sarcopenia assessed with DXA and CT increases the risk of perioperative complications in patients with gastrectomy
European Radiology - Tập 33 Số 7 - Trang 5150-5158 - 2023
We investigated sarcopenia prevalence using various diagnostic criteria based on dual-energy X-ray absorptiometry (DXA) and computed tomography (CT) in gastric cancer patients who underwent gastrectomy, and evaluated the association between sarcopenia and perioperative complications. This retrospective study included consecutive patients with gastric cancer who underwent gastrectomy, and preoperative DXA and CT from January 2013 to November 2020. Body composition was measured using DXA and CT. Height-adjusted DXA-based Appendicular Skeletal Muscle Mass Index (ASMI) and CT-based skeletal muscle cross-sectional area at the L3 level (SMI) were measured. Sarcopenia and sarcopenic obesity were defined using reported cutoff values. The chi-square test and univariate analysis were performed to determine risk factors for significant and severe perioperative complications (Clavien–Dindo Grades ≥ 2 and ≥ 3, respectively). In total, 77 males and 43 females aged 61.4 ± 11.0 years were included. ASMI and SMI were correlated (r = 0.819), but sarcopenia prevalence varied (20.0–63.3%), depending on the criteria applied. Univariate analysis revealed sarcopenia defined using the Asian Working Group on Sarcopenia (AWGS) criteria and sarcopenic obesity as risk factors for significant (odds ratio [OR] 2.76, p = 0.030 vs. OR 4.31, p = 0.002) and severe perioperative complications (OR 3.77, p = 0.036 vs. OR 4.78, p = 0.010). In subgroup analyses, sarcopenia and sarcopenic obesity were significantly associated with perioperative complications only in males. Perioperative complication risk can be predicted from sarcopenia defined using the AWGS criteria and sarcopenic obesity measured using DXA and CT, particularly in males. • The prevalence of sarcopenia varies due to definition differences. • Sarcopenia and sarcopenic obesity are risk factors for significant and severe perioperative complications, particularly in males. • Our results suggest that physicians need to pay attention to perioperative complications after surgical treatment of male patients with sarcopenia and sarcopenic obesity.
Comparative diagnostic accuracy of contrast-enhanced MRI and 18F-FDOPA PET-CT in recurrent glioma
European Radiology - Tập 23 - Trang 2628-2635 - 2013
To compare the diagnostic accuracy of contrast enhanced magnetic resonance imaging (Ce-MRI) and 18F-fluorodopa (18F-FDOPA) positron emission tomography (PET)-computed tomography (CT) for detecting recurrent glioma. In this prospective study, 35 patients (age, 36.62 ± 0.86 years; 80 % male) with histopathologically proven glioma with clinical suspicion of recurrence were evaluated using Ce-MRI and 18F-FDOPA PET-CT. 18F-FDOPA PET-CT images were evaluated qualitatively and semi-quantitatively. Combination of clinical follow-up (minimum 1 year), repeat imaging and/or biopsy (when available) was taken as the reference standard. Based on the reference standard, 26 patients were positive and nine were negative for recurrence. The sensitivity, specificity and accuracy of Ce-MRI were 92.3 %, 44.4 % and 80 % respectively, whereas those of 18F-FDOPA PET-CT were 100 %, 88.89 % and 97.1 % respectively. Results of Ce-MRI and 18F-FDOPA PET-CT were concordant in 74.3 % (29/35) and discordant in 17.1 % of patients (6/35). On McNemar analysis the difference was not statistically significant overall (P = 0.687), for high-grade tumour (P = 0.5) or low-grade tumours (P = 1.0). However, 18F-FDOPA PET-CT was more specific than Ce-MRI overall (P = 0.0002), for high-grade tumour (P = 0.006) and low-grade tumours (P = 0.004). F-FDOPA PET-CT shows a high but comparable diagnostic accuracy to Ce-MRI for the detection of recurrent glioma. However, it is more specific than Ce-MRI.
• Recurrent glioma in the postoperative site remains a diagnostic dilemma.
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F-FDOPA PET-CT shows high diagnostic accuracy for detecting recurrent glioma.
• Diagnostic accuracies for
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F-FDOPA PET-CT and contrast enhanced MRI are comparable.
• However,
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F-FDOPA PET-CT is more specific than Ce-MRI for recurrent glioma.
Hepatocellular carcinoma (HCC) in non-cirrhotic liver: clinical, radiological and pathological findings
European Radiology - Tập 24 - Trang 1446-1454 - 2014
Our aim was to evaluate the clinical and pathological findings, mutidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI) appearances, treatment and 1-year survival of patients with HCC in non-cirrhotic liver. Histopathological and laboratory findings of 30 non-cirrhotic patients with 32 HCCs were reviewed retrospectively. MDCT and gadobenate dimeglumine-enhanced MR images were evaluated in consensus by two radiologists in terms of HCC size, presence of tumour capsule, necrosis, haemorrhage, fat and calcification, and vascular involvement. Imaging patterns were compared directly with HCC findings in a matched group of cirrhotic patients. No differences between non-cirrhotic and cirrhotic patients were noted in terms of serum α-fetoprotein levels (elevated in 11 [36.7 %] and 21 [35 %] patients, respectively). The imaging appearance at CT and contrast-enhanced MRI was typical in 27 (84.3 %) and 28 (87.5 %) cases respectively. Most lesions presented as a well-differentiated large solitary mass, with well-defined margins, areas of necrosis and peripheral capsule. No significant differences in HCC pattern were observed between cirrhotic and non-cirrhotic liver. In non-cirrhotic patients, HCC is more likely to manifest as an asymptomatic mass with elevation of serum tumour markers similar to that seen in cirrhotic patients. HCC in cirrhotic and non-cirrhotic livers show similar enhancement patterns.
Inter-sonographer reproducibility of quantitative ultrasound outcomes and shear wave speed measured in the right lobe of the liver in adults with known or suspected non-alcoholic fatty liver disease
European Radiology - - 2018
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