Chelation of the rare-earth element gadolinium (Gd) with diethylenetriaminepentaacetic acid (DTPA) results in a strongly paramagnetic, stable complex that is well tolerated in animals. The strongly paramagnetic gadolinium complex reduces hydrogen-proton relaxation times even in low concentrations (less than 0.01 mmol/L). The pharmacokinetic behavior of intravenously delivered Gd-DTPA is similar to the well known iodinated contrast agents used in urography and angiography; excretion is predominantly through the kidneys with greater than 90% recovery in 24 hr. The intravenous LD50 of the meglumine salt of Gd-DTPA is 10 mmol/kg for the rat; in vivo there is no evidence of dissociation of the gadolinium ion from the DTPA ligand. The combination of strong proton relaxation, in-vivo stability, rapid urinary excretion, and high tolerance favors the further development and the potential clinical application of gadolinium-DTPA as a contrast enhancer in magnetic resonance imaging.

https://www.ajronline.org/doi/pdfplus/10.2214/ajr.142.3.619

Characteristics of gadolinium-DTPA complex: a potential NMR contrast agent.

Recent technologic advances have markedly enhanced the clinical applications of computed tomography (CT). While the benefits of CT exceed the harmful effects of radiation exposure in patients, increasing radiation doses to the population have raised a compelling case for reduction of radiation exposure from CT. Strategies for radiation dose reduction are difficult to devise, however, because of a lack of guidelines regarding CT examination and scanning techniques. Various methods and strategies based on individual patient attributes and CT technology have been explored for dose optimization. It is the purpose of this review article to outline basic principles of CT radiation exposure and emphasize the need for CT radiation dose optimization based on modification of scanning parameters and application of recent technologic innovations.

Strategies for CT radiation dose optimization.

In the past decade, the tremendous advances in computed tomography (CT) technology and applications have increased the clinical utilization of CT, creating concerns about individual and population doses of ionizing radiation. Scanner manufacturers have subsequently implemented several options to appropriately manage or reduce the radiation dose from CT. Modulation of the x-ray tube current during scanning is one effective method of managing the dose. However, the distinctions between the various tube current modulation products are not clear from the product names or descriptions. Depending on the scanner model, the tube current may be modulated according to patient attenuation or a sinusoidal-type function. The modulation may be fully preprogrammed, implemented in near-real time by using a feedback mechanism, or achieved with both preprogramming and a feedback loop. The dose modulation may occur angularly around the patient, along the long axis of the patient, or both. Finally, the system may allow use o...

https://pubs.rsna.org/doi/pdf/10.1148/rg.262055138

CT dose reduction and dose management tools: overview of available options.

Osteochondroma represents the most common bone tumor and is a developmental lesion rather than a true neoplasm. It constitutes 20%–50% of all benign bone tumors and 10%–15% of all bone tumors. Its radiologic features are often pathognomonic and identically reflect its pathologic appearance. Osteochondromas are composed of cortical and medullary bone with an overlying hyaline cartilage cap and must demonstrate continuity with the underlying parent bone cortex and medullary canal. Osteochondromas may be solitary or multiple, the latter being associated with the autosomal dominant syndrome, hereditary multiple exostoses (HME). Complications associated with osteochondromas are more frequent with HME and include deformity (cosmetic and osseous), fracture, vascular compromise, neurologic sequelae, overlying bursa formation, and malignant transformation. Malignant transformation is seen in 1% of solitary osteochondromas and in 3%–5% of patients with HME. Continued lesion growth and a hyaline cartilage cap greate...

Imaging of osteochondroma: variants and complications with radiologic-pathologic correlation.

Strategies for reducing radiation dose in CT.

In order to determine the clinical usefulness of nuclear magnetic resonance (NMR) imaging, the investigators examined a variety of normal volunteers, patients with neoplastic lesions, and experimental animals. Preliminary results were obtained with the use of potential contrast agents. It was found that imaging applications of NMR in the vascular system, spine, brain, lung, and mediastinum offer certain advantages over other modalities. The absence of biological hazard as well as the ability to obtain unenhanced, noninvasive, gated images of the vascular system, as demonstrated in this study, make NMR particularly attractive. In addition to single-section capability, NMR makes it possible to obtain volume images of the spine and other organs which can be displayed in any desired plane or section thickness.

Preliminary experimental results in humans and animals with a superconducting, whole-body, nuclear magnetic resonance scanner

The effect of different mAs settings on computed tomobraphy (CT) image quality was evaluated by a clinical study and phantom studies. In the clinical portion of this study, a number of CT images, obtained at various mAs settings, were reviewed by experienced CT interpreters. From these same images, graphs were charted of the root-mean-standard deviation (RMSD) vs. body size; there appeared to be a linear relationship between noise, as measured by RMSD, and body size. A performance phantom was used to evaluate the effect of the different mAs settings on resolution. There was some loss in low contrast resolution at 6 and 20 mAs; however, the resolution was identical at 40 and 100 mAs.

The effect of mAs variation upon computed tomography image quality as evaluated by in vivo and in vitro studies

MR angiography of peripheral, carotid, and coronary arteries.

A 22 gauge "skinny core" (Madayag) biopsy needle, an 18 gauge Menghini needle, and a 14 gauge Tru-cut needle were compared in 51 patients The Madayag needle was found to have a high recovery rate and provided adequate histological information in a large percentage of cases However, the larger needles more consistently demonstrated a higher recovery rate and diagnostic specimen than the Madayag needle The authors recommend that the radiologist become familiar with all three types of needles to facilitate selection of the proper instrument in each case

Clinical comparison of small-and large-caliber cutting needles for biopsy.

Pelvic NMR scans were obtained on 29 patients using a 0.3 T superconducting magnet system. Pathologies studied included four bladder carcinomas, four prostatic carcinomas, four ovarian dermoid cysts, three ovarian cysts, three endometrial carcinomas, two endometriomas, and one each of serous cystadenoma of the ovary, benign prostatic hypertrophy, pelvic hematoma, and undifferentiated sarcoma. NMR is a very promising method for characterizing pelvic masses and in staging pelvic malignancies. It can show primary tumors of the prostate, bladder, and uterus and reveals tumor extension into pelvic fat. The pelvis is particularly well suited to NMR scanning because of the abundant natural contrast provided by pelvic fat and by urine in the bladder and gas in the bowel. There is also less motion blurring than in the upper abdomen and chest because there is relatively little respiratory motion of pelvic organs. Various pulse sequences were used in scanning the pelvis; their relative merits are discussed.

https://www.ajronline.org/doi/pdfplus/10.2214/ajr.141.6.1111

Joseph P. LiPuma

Papers

Preliminary experimental results in humans and animals with a superconducting, whole-body, nuclear magnetic resonance scanner

The effect of mAs variation upon computed tomography image quality as evaluated by in vivo and in vitro studies

MR angiography of peripheral, carotid, and coronary arteries.

Clinical comparison of small-and large-caliber cutting needles for biopsy.

NMR scanning of the pelvis: initial experience with a 0.3 T system