Current Issue : April - June Volume : 2017 Issue Number : 2 Articles : 7 Articles
Background: To evaluate and compare the utility of 18F-fluorocholine (18F-CH) PET/CT versus 3-Tesla multiparametric\nMRI (mpMRI) without endorectal coil to detect tumor recurrences in patients with biochemical relapse following\nradical prostatectomy (RP). Secondarily, to identify possible prognostic variables associated with mpMRI and 18F-CH\nPET/CT findings.\nMethods: Retrospective study of 38 patients who developed biochemical recurrence after RP between the years 2011\nand 2015 at our institution. PET/CT and mpMRI were both performed within 30 days of each other in all patients. The\nPET/CT was reviewed by a nuclear medicine specialist while the mpMRI was assessed by a radiologist, both of whom\nwere blinded to outcomes.\nResults: The median prostate-specific antigen (PSA) value pre-MRI/PET-CT was 0.9 ng/mL (interquartile range 0.4ââ?¬â??2.\n2 ng/mL). There were no differences in the detection rate between 18F-CH PET/CT and mpMRI for local recurrence\n(LR), lymph node recurrence (LNR) and bone metastases (BM). Separately, mpMRI and 18F-CH PET/CT were positive for\nrecurrence in 55.2% and 52.6% of cases, respectively, and in 65.7% of cases when findings from both modalities were\nconsidered together. The detection of LR was better with combined mpMRI and choline PET/CT versus choline PET/CT\nalone (34.2% vs 18.4%, p = 0.04). Salvage treatment was modified in 22 patients (57.8%) based on the imaging findings.\nPSA values on the day of biochemical failure were significantly associated with mpMRI positivity (adjusted odds ratio\n(OR): 30.9; 95% confidence interval (CI): 1.5ââ?¬â??635.8). Gleason score > 7 was significantly associated with PET/CT positivity\n(OR: 13.9; 95% CI: 1.5ââ?¬â??125.6). A significant association was found between PSA doubling time (PSADT) (OR: 1.3; 95%\nCI: 1.0ââ?¬â??1.7), T stage (OR: 21.1; 95% CI: 1.6ââ?¬â??272.1), and LR.\nConclusions: Multiparametric MRI and 18F-CH PET/CT yield similar detection rates for LR, LNR and pelvic BM. The\ncombination of both imaging techniques provides a better LR detection versus choline PET/CT alone. The initially\nplanned salvage treatment was modified in 57.8% of patients due to imaging findings. In addition to PSA values,\nGleason score, T stage, and PSADT may provide valuable data to identify those patients that are most likely to benefit\nfrom undergoing both imaging procedures....
Purpose. This study aims to evaluate the process of brain development in neonates using combined amide proton transfer (APT)\nimaging and conventional magnetization transfer (MT) imaging. Materials and Methods. Case data were reviewed for all patients\nhospitalized in our institution�s neonatal ward. Patients underwent APT and MT imaging (a single protocol) immediately following\nthe routine MR examination. Single-slice APT/MT axial imaging was performed at the level of the basal ganglia. APT and MT ratio\n(MTR) measurements were performed in multiple brain regions of interest (ROIs). Data was statistically analyzed in order to assess\nfor significant differences between the different regions of the brain or correlation with patient gestational age. Results. A total of\n38 neonates were included in the study, with ages ranging from 27 to 41 weeks� corrected gestational age. There were statistically\nsignificant differences in both APT and MTR measurements between the frontal lobes, basal ganglia, and occipital lobes (APT:\nfrontal lobe versus occipital lobe ...
Introduction. We aim to regularize measurement values in three-dimensional (3D) computed tomography (CT) reconstructed\nimages for higher-precision 3D analysis, focusing on length-based 3D cephalometric examinations. Methods. We measure the\nlinear distances between points on different skull models using Vernier calipers (real values).We use 10 differently tilted CT scans\nfor 3D CT reconstruction of the models and measure the same linear distances from the picture archiving and communication\nsystem (PACS). In both cases, each measurement is performed three times by three doctors, yielding nine measurements. The real\nvalues are compared with the PACS values. Each PACS measurement is revised based on the display field of view (DFOV) values\nand compared with the real values. Results. The real values and the PACS measurement changes according to tilt value have no\nsignificant correlations (...
Increased interest of clinicians for using 3.0 T magnetic resonance imaging (MRI), as\nimaging modality of choice for their patients, has been evident in the past few years.\nThe aim of this study was to compare the technical quality of the obtained tomography\nusing 3.0 T and 1.5 T MRI, and to compare the subjective feeling of discomfort\nof patients and subjective acoustic noise experience during imaging using MRI at 3.0\nT and 1.5 T. Brain MRI (1.5 and 3.0 T) was performed in 58 patients, according to a\nstandardized protocol. All studies have been randomly described by independent two\nradiologists. The reference standard for the existence of technical artifact is established\non the basis of both radiologistsââ?¬â?¢ consensus. We also compared the subjective\nfeelings of the discomfort and acoustic noise during the both MRI (1.5 T and 3.0 T)\nexams. Artifacts were significantly more common during 3.0 T MRI in comparison\nwith the 1.5 T MRI (Ãâ?¡ 2 = 5.286, P < 0.05), as well as in male patients (Ãâ?¡ 2 = 8.841, P <\n0.05), and subjective assessments of discomfort and acoustic noise were higher in patients\nwho underwent imaging using 3.0 T MRI, (Ãâ?¡ 2 = 125.959, df = 1, P < 0.001) and\nin females (Ãâ?¡ 2 = 195.449, df = 1, P < 0.001). Additional research is needed to prove\nthat appropriate information for patients about the discomfort during 3.0 T MRI and\ntheir psychological preparation is very important element for optimal use of 3.0 T\nMRI in daily clinical practice....
Purpose: In patients with obstructive lung diseases, alteration of intrathoracic pressure\nis closely related to hyperinflation and leads to hemodynamic impairments.\nBoth intrathoracic pressure and hemodynamics are affected by the respiratory phase.\nIn fact, a previous study showed that respiratory phasic variations in the superior\nvena cava (SVC) area significantly correlated with the extent of emphysema. Chronic\nobstructive pulmonary disease (COPD) and bronchial asthma manifest different pathophysiological\nchanges in hyperinflation and hemodynamics. The current study\nwas conducted to evaluate differences in respiratory variations in the cross-sectional\narea of the SVC between patients with COPD and with asthma. Materials and Methods:\nWe measured the SVC area and calculated the ratio of the SVC area on inspiratory\nand expiratory scans (i/e-SVC ratio) in 66 patients with COPD and 16 patients\nwith asthma. The correlations of the i/e-SVC ratios with airflow limitation, pulmonary\nsmall vessels less than 5 mm2 (%cross-sectional area [%CSA] < 5), and respiratory\nchanges in lung volume (i/e-LV) obtained by inspiratory and expiratory computed\ntomography (CT) images were evaluated. Results: There was no significant\ndifference in i/e-SVC ratio between COPD and asthma groups. In COPD patients,\nthe i/e-SVC ratio significantly correlated with the %CSA < 5 (à= âË?â??0.433, P = 0.003),\ni/e-LV ratio (à= âË?â??0.371, P = 0.011), and percent of predicted forced expiratory volume\nin 1 second (FEV1% predicted) (à= âË?â??0.474, P = 0.001), whereas in asthma patients,\nthere were no significant correlations between the i/e-SVC ratio and those\nfunctional parameters. Conclusion: There would be differences in the relationship\nbetween intrathoracic pressure and cardiopulmonary hemodynamics between COPD...
Introduction: The literature on surgical salvage, i.e. lung resections in patients who develop a local recurrence\nfollowing stereotactic ablative radiotherapy (SABR), is limited. We describe our experience with salvage surgery in\nnine patients who developed a local recurrence following SABR for early stage non-small cell lung cancer (NSCLC).\nMethods: Patients who underwent surgical salvage for a local recurrence following SABR for NSCLC were identified\nfrom two Dutch institutional databases. Complications were scored using the Dindo-Clavien-classification.\nResults: Nine patients who underwent surgery for a local recurrence were identified. Median time to local\nrecurrence was 22 months. Recurrences were diagnosed with CT- and/or 18FDG-PET-imaging, with four patients\nalso having a pre-surgical pathological diagnosis. Extensive adhesions were observed during two resections,\nrequiring conversion from a thoracoscopic procedure to thoracotomy during one of these procedures. Three\npatients experienced complications post-surgery; grade 2 (N = 2) and grade 3a (N = 1), respectively. All resection\nspecimens showed viable tumor cells. Median length of hospital stay was 8 days (range 5ââ?¬â??15 days) and 30-day\nmortality was 0 %. Lymph node dissection revealed mediastinal metastases in 3 patients, all of whom received\nadjuvant therapy.\nConclusions: Our experience with nine surgical procedures for local recurrences post-SABR revealed two grade IIIa\ncomplications, and a 30-day mortality of 0 %, suggesting that salvage surgery can be safely performed after SABR....
Background: Image guided radiotherapy (IGRT) is an essential pre-requisite for delivering high precision\nradiotherapy. We compared daily variation detected by two non-ionizing imaging modalities (surface imaging and\ntrans-abdominal ultrasound, US) to verify prostate patient setup and internal organ variations.\nMethods: Forty patients with organ confined prostate cancer and candidates to curative radiotherapy were\nenrolled in this prospective study. At each treatment session, after laser alignment, all patients received imaging by\na 3D-surface and a 3D-US system. The shifts along the three directions (anterior-posterior AP, cranial-caudal CC, and\nlater-lateral LL) were measured in terms of systematic and random errors. Then, we performed statistical analysis on\nthe differences and the possible correlations between the two modalities.\nResults: For both IGRT modalities, surface imaging and US, 1318 acquisitions were collected. According with Shapiro\nWilk test, the positioning error distributions were not Gaussian for both modalities.\nThe differences between the systematic errors detected by the two modalities were statistically significant only in LL\ndirection (p < 0.05), while the differences between the random errors were not statistically significant in any directions.\nThe 95% confidence interval of the residual errors obtained by subtracting the random errors detected with surface\nimages to those detected with US was included in the range from âË?â??7 mm to 7 mm corresponding to the minimum\nPTV margin adopted in AP direction in our clinical routine.\nConclusions: From our data, it emerges that setup misalignments measured by surface imaging can be predictive of\nUS displacements after the adjustment for systematic errors. Moreover, surface imaging can detect setup errors\npredictive of registration errors measured by US. This data suggest that the two IGRT modalities could be considered\nas complementary to each other and could represent a daily ââ?¬Å?low-costââ?¬Â and non-invasive IGRT modality in prostate\ncancer patients....
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