Showing papers in "Radiology in 2013"
TL;DR: The use of mammography plus tomosynthesis in a screening environment resulted in a significantly higher cancer detection rate and enabled the detection of more invasive cancers.
Abstract: We found a significant increase in cancer detection rates, particularly for invasive cancers, and a simultaneous decrease in false-positive rates with use of mammography plus tomosynthesis compared with mammography alone.
890 citations
TL;DR: In this article, the authors proposed a set of recommendations specifically aimed at subsolid nodules, which are based on the original Fleischner Society guidelines for incidentally detected solid nodules.
Abstract: This report is to complement the original Fleischner Society recommendations for incidentally detected solid nodules by proposing a set of recommendations specifically aimed at subsolid nodules. The development of a standardized approach to the interpretation and management of subsolid nodules remains critically important given that peripheral adenocarcinomas represent the most common type of lung cancer, with evidence of increasing frequency. Following an initial consideration of appropriate terminology to describe subsolid nodules and a brief review of the new classification system for peripheral lung adenocarcinomas sponsored by the International Association for the Study of Lung Cancer (IASLC), American Thoracic Society (ATS), and European Respiratory Society (ERS), six specific recommendations were made, three with regard to solitary subsolid nodules and three with regard to multiple subsolid nodules. Each recommendation is followed first by the rationales underlying the recommendation and then by specific pertinent remarks. Finally, issues for which future research is needed are discussed. The recommendations are the result of careful review of the literature now available regarding subsolid nodules. Given the complexity of these lesions, the current recommendations are more varied than the original Fleischner Society guidelines for solid nodules. It cannot be overemphasized that these guidelines must be interpreted in light of an individual's clinical history. Given the frequency with which subsolid nodules are encountered in daily clinical practice, and notwithstanding continuing controversy on many of these issues, it is anticipated that further refinements and modifications to these recommendations will be forthcoming as information continues to emerge from ongoing research.
788 citations
TL;DR: PED offers a reasonably safe and effective treatment of large or giant intracranial internal carotid artery aneurysms, demonstrated by high rates of completeAneurysm occlusion and low rates of adverse neurologic events; even in aneurYSms failing previous alternative treatments.
Abstract: The Pipeline for Uncoilable or Failed Aneurysms study demonstrated a high rate (78 of 108, 73.6%) of complete occlusion of large and giant wide-necked aneurysms of the internal carotid artery and a reasonably low rate of major safety events (6 of 107, 5.6% rate of major stroke or neurologic death).
728 citations
TL;DR: Addition of tomosynthesis to digital mammography offers the dual benefit of significantly increased diagnostic accuracy and significantly reduced recall rates for noncancer cases.
Abstract: The addition of tomosynthesis to digital mammography offers the dual benefit of improved diagnostic accuracy and significant reduction in false-positive recall rate, thereby avoiding unnecessary additional testing and decreasing attendant anxiety, inconvenience, and cost for women.
408 citations
TL;DR: MR imaging-PDFF showed promise for assessment of hepatic steatosis grade in patients with NAFLD, and was significantly correlated with histologic steatotic grade.
Abstract: MR imaging with proton density fat fraction (PDFF) permitted high overall accuracy with moderate sensitivity and high specificity for classification of dichotomized steatosis grade, and these results support the conduct of further studies to help validate MR imaging–PDFF as a biomarker of hepatic steatosis in nonalcoholic fatty liver disease.
394 citations
TL;DR: Texture parameters derived from CT images of NSCLC have the potential to act as imaging correlates for tumor hypoxia and angiogenesis.
Abstract: Texture analysis of CT images of non-small cell lung cancer may have the potential to act as imaging correlates for tumor hypoxia and angiogenesis.
385 citations
Emory University1, Henry Ford Health System2, University of Virginia3, National Institutes of Health4, Northwestern University5, Science Applications International Corporation6, Harvard University7, University of Texas MD Anderson Cancer Center8, Boston University9, Stanford University10, Thomas Jefferson University11
TL;DR: This analysis demonstrates a method for consistent image feature annotation capable of reproducibly characterizing brain tumors and shows that radiologists' estimations of macroscopic imaging features can be combined with genetic alterations and gene expression subtypes to provide deeper insight to the underlying biologic properties of GBM subsets.
Abstract: While data are still being generated from additional cases, the initial findings connecting radiology, outcome, and genomics clearly demonstrate the power of this approach; we demonstrated that noninvasive, imaging-based features can be used as prognostic biomarkers.
372 citations
TL;DR: Patients undergoing tomosynthesis plus digital mammography had significantly lower screening recall rates, and the greatest reductions were for those younger than 50 years and those with dense breasts.
Abstract: Although all breast density and age subgroups benefitted from the addition of tomosynthesis to conventional digital mammography, the patients receiving the greatest benefit were women with dense breasts and those younger than 50 years.
364 citations
TL;DR: In this paper, fine-texture features (lower entropy, kurtosis, and standard deviation; higher uniformity and skewness) were associated with a poorer 5-year overall survival rate in patients with colorectal cancer.
Abstract: Fine-texture features (lower entropy, kurtosis, and standard deviation; higher uniformity and skewness) were associated with a poorer 5-year overall survival rate in patients with colorectal cancer.
357 citations
TL;DR: Prebiopsy MR imaging combined with transrectal US-guided TB increases biopsy performance in detecting PCa, especially clinically significant PCa.
Abstract: Prebiopsy MR imaging results combined with transrectal US–guided targeted biopsy increase the performance of biopsy conducted without knowledge of imaging results in diagnosing clinically significant and anterior prostate cancer.
349 citations
TL;DR: Clinical imaging can enable us to define intratumoral Darwinian dynamics before and during therapy, and place clinical imaging in an increasingly central role in the development of evolution-based patient-specific cancer therapy.
Abstract: Cancer therapy, even when highly targeted, typically fails because of the remarkable capacity of malignant cells to evolve effective adaptations. These evolutionary dynamics are both a cause and a consequence of cancer system heterogeneity at many scales, ranging from genetic properties of individual cells to large-scale imaging features. Tumors of the same organ and cell type can have remarkably diverse appearances in different patients. Furthermore, even within a single tumor, marked variations in imaging features, such as necrosis or contrast enhancement, are common. Similar spatial variations recently have been reported in genetic profiles. Radiologic heterogeneity within tumors is usually governed by variations in blood flow, whereas genetic heterogeneity is typically ascribed to random mutations. However, evolution within tumors, as in all living systems, is subject to Darwinian principles; thus, it is governed by predictable and reproducible interactions between environmental selection forces and cell phenotype (not genotype). This link between regional variations in environmental properties and cellular adaptive strategies may permit clinical imaging to be used to assess and monitor intratumoral evolution in individual patients. This approach is enabled by new methods that extract, report, and analyze quantitative, reproducible, and mineable clinical imaging data. However, most current quantitative metrics lack spatialness, expressing quantitative radiologic features as a single value for a region of interest encompassing the whole tumor. In contrast, spatially explicit image analysis recognizes that tumors are heterogeneous but not well mixed and defines regionally distinct habitats, some of which appear to harbor tumor populations that are more aggressive and less treatable than others. By identifying regional variations in key environmental selection forces and evidence of cellular adaptation, clinical imaging can enable us to define intratumoral Darwinian dynamics before and during therapy. Advances in image analysis will place clinical imaging in an increasingly central role in the development of evolution-based patient-specific cancer therapy.
© RSNA, 2013
TL;DR: Following adjustment for presumed risk factors, the incidence of CIN was not significantly different from contrast material-independent AKI, suggesting that intravenous iodinated contrast media may not be the causative agent in diminished renal function after contrast material administration.
Abstract: The current clinical definition of contrast material–dependent acute kidney injury (AKI) is confounded by a sufficiently high false-positive rate of contrast material–independent AKI so as to make detection of contrast material–induced nephropathy impossible, even among patients with the most compromised renal function.
TL;DR: A new liver allocation policy featuring improved imaging criteria for hepatocellular carcinoma exceptions has been developed and approved by the Organ Procurement and Transplantation Network–United Network for Organ Sharing, in late 2011; radiologists in accredited transplantation centers in the United States are now challenged to implement the policy.
Abstract: A new liver allocation policy featuring improved imaging criteria for hepatocellular carcinoma exceptions has been developed and approved by the Organ Procurement and Transplantation Network–United Network for Organ Sharing, in late 2011; radiologists in accredited transplantation centers in the United States are now challenged to implement the policy.
TL;DR: Heading is associated with abnormal white matter microstructure and with poorer neurocognitive performance and this relationship is not explained by a history of concussion.
Abstract: Our current study results suggest that a nonlinear relationship exists between exposure to heading during the previous year, as measured by the Einstein Heading Questionnaire, and both abnormal white matter microstructure and poorer neurocognitive performance on a memory test.
TL;DR: IV LOCM is a nephrotoxic risk factor in patients with a stable eGFR less than 30 mL/min/1.73 m(2) or greater, with a trend toward significance at 30-44 mL/Min/1m(2), while IV LOCM does not appear to be a nePHrotoxic Risk Factor in patientsWith stable renal function.
Abstract: Intravenous low-osmolality contrast material is a nephrotoxic risk factor in patients with stable estimated glomerular filtration (eGFR) rate of less than 30 mL/min/1.73 m2, with a trend toward significance in patients with stable eGFR of 30–44 mL/min/1.73 m2.
TL;DR: Investigating causes of disagreement in identifying honeycombing at chest computed tomography found that disagreement is largely caused by conditions that mimic Honeycombing.
Abstract: Even experienced radiologists may disagree on the identification of the presence of honeycombing, and this disagreement is caused mainly by the misinterpretation of conditions that may mimic honeycombing, such as traction bronchiectasis and emphysema
TL;DR: Bilateral dual-energy contrast agent-enhanced digital mammography was feasible and easily accomplished and was used to detect known primary tumors at a rate comparable to that of MR imaging and higher than that of conventionaldigital mammography.
Abstract: Bilateral dual-energy contrast-enhanced digital mammography was feasible, easily accomplished, and depicted known primary tumors at a rate comparable to that of MR imaging and higher than that of conventional digital mammography.
IBM1
TL;DR: Although apparent diffusion coefficient remains a valid and useful clinical marker, it is clear that more advanced processing of diffusion MR Imaging data is necessary if one wants, someday, diffusion MR imaging to become a “virtual biopsy” tool.
Abstract: Although apparent diffusion coefficient remains a valid and useful clinical marker, it is clear that more advanced processing of diffusion MR imaging data is necessary if one wants, someday, diffusion MR imaging to become a “virtual biopsy” tool.
TL;DR: Controlled contrast medium-induced nephropathy studies demonstrate similar rates of acute kidney injury, dialysis, and death in patients who received intravenous contrast medium and in control groups of patients who did not receive contrast medium as mentioned in this paper.
Abstract: Controlled contrast medium-induced nephropathy studies demonstrate similar rates of acute kidney injury, dialysis, and death in patients who received intravenous contrast medium and in control groups of patients who did not receive contrast medium.
TL;DR: PDFF measurement by MR imaging provided a noninvasive, accurate estimation of the presence and grading of hepatic steatosis in patients with NAFLD.
Abstract: Proton density fat fraction provides an accurate estimation of the presence and grading of hepatic steatosis between nonexistent or mild and moderate or severe forms in patients with nonalcoholic fatty liver disease.
TL;DR: An overview of cardiac masses is provided and the optimal MR imaging techniques for their assessment are reviewed, which include contrast material-enhanced MR imaging, which enables discrimination of different tissue characteristics, such as water and fat content.
Abstract: Cardiac masses are usually first detected at echocardiography. In their further evaluation, cardiac magnetic resonance (MR) imaging has become a highly valuable technique. MR imaging offers incremental value owing to its larger field of view, superior tissue contrast, versatility in image planes, and unique ability to enable discrimination of different tissue characteristics, such as water and fat content, which give rise to particular signal patterns with T1- and T2-weighted techniques. With contrast material-enhanced MR imaging, additional tissue properties such as vascularity and fibrosis can be demonstrated. MR imaging can therefore contribute to the diagnosis of a cardiac mass as well as be used to detail its relationship to other cardiac and extracardiac structures. These assessments are important to plan therapy, such as surgical intervention. In addition, serial MR studies can be used to monitor tumor regression after surgery or chemotherapy. Primary cardiac tumors are very rare; metastases and pseudotumors (eg, thrombus) are much more common. This article provides an overview of cardiac masses and reviews the optimal MR imaging techniques for their assessment.
TL;DR: MR imaging showed heterogeneous results of diagnostic performances for restaging rectal cancer after neoadjuvant treatment, but significantly better results were demonstrated when DW imaging was used or with experienced observers.
Abstract: MR imaging showed moderate results for tumor staging, with significantly better results when diffusion-weighted imaging or experienced observers were used; moderate results were seen for restaging of circumferential resectionmargin, but lymph node staging remains challenging.
TL;DR: The purpose of this review is to highlight the added role of MR imaging in the treatment stratification and overall care of patients with endometrial, cervical, or ovarian cancer.
Abstract: Advances in MR imaging techniques, along with the growing role of the radiologist as part of a multidisciplinary treatment-planning team, have become central in tailoring treatment options and frequently lead to modifications in the therapeutic approach in patients with gynecologic malignancies.
TL;DR: SWElastography provides more accurate correlation of liver elasticity with liver fibrosis stage compared with transient elastography, especially in identification of stage F2 or greater.
Abstract: Shear-wave elastography enables better biopsy correlated assessment of liver fibrosis compared with transient elastography, especially for early fibrosis, and gives objective assessment of splenic elasticity, correlated with liver fibrosis staging in chronic hepatitis B patients.
TL;DR: Enhancement at multiphasic multidetector CT, if prospectively validated, may assist in the discrimination of clear cell RCC from oncocytoma, papillary RCC, and chromophobe RCC.
Abstract: Multiphasic multidetector CT, if validated in a large prospective trial, may assist in the discrimination of clear cell renal cell carcinoma (RCC) from oncocytoma, papillary RCC, and chromophobe RCC.
TL;DR: Radiologists performed well with both PI-RADS and Likert scales for tumor localization, although, in the TZ, performance was better with the Lkert scale than the PI- RADS scale.
Abstract: Three experienced radiologists from our institution performed well with both the Prostate Imaging Reporting and Data System (PI-RADS) and Likert scales in tumor localization, with radical prostatectomy as the reference standard, and performance was better in the peripheral zone than in the transition zone (TZ); however, performance with the PI-RADS scale was lower than with the Likert scale in the TZ and interreader agreement was poor in the TZ, thereby indicating the need for continued development of the PI-RADS scale, particularly in the TZ.
TL;DR: The combination of 10th percentile ADC, average ADC, and T2-weighted skewness with CAD is promising in the differentiation of prostate cancer from normal tissue.
Abstract: The findings of this retrospective study suggest that computer-aided diagnosis based on a combination of quantitative imaging features derived from multiparametric endorectal MR images might be effective in distinguishing prostate cancer from normal prostate tissue and that apparent diffusion coefficient features and volume transfer constant moderately correlate with tumor Gleason score.
TL;DR: There is marked variability in penumbra and infarct prediction among various deconvolution techniques and highlights the need for standardization of perfusion CT in stroke.
Abstract: In a well-characterized and large data set, we have found considerable variation in the accuracy of core and penumbra detection, and the perfusion thresholds used to determine them, with commonly used perfusion algorithms.
TL;DR: QSM provides superior sensitivity over R2* mapping in the detection of MS-related tissue changes in the basal ganglia, which suggests that QSM can serve as a sensitive measure at the earliest stage of the disease.
Abstract: We have showed that quantitative susceptibility mapping has superior sensitivity in the assessment of multiple sclerosis-related tissue changes in the basal ganglia than does R2* relaxation rate mapping, with susceptibility changes already observable in patients with clinically isolated syndrome.
TL;DR: Imaging and CSF biomarkers can improve prediction of conversion from MCI to AD compared with baseline clinical testing, and FDG PET appears to add the greatest prognostic information.
Abstract: A model combining clinical information with MR imaging, fluorine 18 fluorodeoxyglucose (FDG) PET, and cerebrospinal fluid markers yielded the highest accuracy for predicting future mild cognitive impairment conversion; however, the most efficient model included only FDG PET with the clinical covariates.