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In vivo 1H MR spectroscopy of thyroid carcinoma
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Abstracts / Journal of Clinical Imaging 29 (2005) 373–377
Cancer Agency, British Columbia, Canada, and reviews the literature on this topic. Using the database at PETSCAN Vancouver, we identified imaged patients with a diagnosis of breast cancer. We then conducted a retrospective review of these patients’ BC Cancer Agency charts to extract demographic and follow-up information. Between November 2000 and March 2003, we identified 165 patients with histologically confirmed breast cancer who had undergone PET scanning, were registered at the BC Cancer Agency, and had follow-up information. The median patient age was 52 years. The sensitivity of PET in detecting axillary metastases was 28%, and the specificity was 86%. At diagnosis, 5% of patients were diagnosed with distant metastases. In patients undergoing PET scanning because of suspected recurrence, the sensitivity and specificity for detecting recurrence were 89% and 88%, respectively. Distant metastases were demonstrated in 30% of patients who were thought only to have local–regional recurrence. The results suggest that there are two clinical situations in which PET appears to be particularly valuable. The first is in the evaluation of patients who are suspected of having a tumor recurrence. The other is in identifying patients with multifocal or distant sites of malignancy who otherwise appear to have an isolated, potentially curable, local–regional recurrence.
Multidetector computed tomography-guided treatment strategy in patients with non-ST elevation acute coronary syndromes: a pilot study Dorgelo J, Willems TP, Geluk CA, van Ooijen PMA, Zijlstra F, Oudkerk M (Department of Radiology, University Hospital Groningen, Groningen, The Netherlands). Eur Radiol 2005;15:708–713. Patients with non-ST elevation acute coronary syndrome (ACS) and evidence of myocardial ischaemia are scheduled for coronary angiography (CAG). In most patients, CAG remains a single diagnostic procedure only. A prospective study was performed to evaluate whether 16-slice multidetector CT (MDCT) could predict treatment of the patients and to determine how many CAGs could have been prevented by MDCT scanning prior to CAG. Twentytwo patients with ACS were scanned prior to CAG. Based on MDCT data, a fictive treatment was proposed and compared with a CAG-based treatment. Excellent accuracy was observed to detect significant stenoses using MDCT (sensitivity 94%, specificity 96%). In 45%, no PCI was performed during CAG because of the absence of significant coronary artery disease (27%) or severe coronary artery disease, demanding CABG (18%). MDCT predicted correct treatment in 86%. By using MDCT data, 32% of the CAGs could have been prevented.
In vivo 1H MR spectroscopy of thyroid carcinoma King AD, Yeung DKW, Ahuja AT, Tse GMK, Chan ABW, Lam SSL, van Hasselt AC (Department of Diagnostic Radiology and Organ Imaging, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR China). Eur J Radiol 2005;54:112 –117. The aim of this study was to determine if proton magnetic resonance spectroscopy (1H MRS) of thyroid carcinoma is feasible and to determine if 1 H MRS spectra of malignant tumors differ from that of normal thyroid tissue. We performed 1H MRS at 1.5 T at echo times (TE) 136 and 272 ms to examine eight patients, with thyroid cancer (primary tumor or nodal metastasis) larger than 1 cm3 in size, and five volunteers with normal thyroids. Spectra acquired from six primary tumors (three anaplastic carcinomas, two papillary carcinomas, and one follicular carcinoma) and two nodes (two papillary carcinoma metastases) were analyzed in the time domain using a nonlinear least squares fitting algorithm with incorporation of prior knowledge. Choline (3.2 ppm) was identified in all solid carcinomas, with a mean choline/creatine of 4.3 at TE 136 ms and 5.4 at TE 272 ms. Ratios for malignant tumors at TE 136 ms ranged from 1.6 in well-differentiated follicular carcinoma to 9.4 in anaplastic carcinoma. No choline was detected in normal thyroid tissues. Our results showed that 1H
MRS is a feasible technique for the evaluation of malignant thyroid tumors larger than 1 cm3 and that proton spectra of malignant tumors differ from that of normal thyroid tissue.
Imaging of macrophage-related lung diseases Marten K, Hansell DM (Department of Radiology, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK). Eur Radiol 2005;15:727–741. Macrophage-related pulmonary diseases are a heterogeneous group of disorders characterized by macrophage accumulation, activation, or dysfunction. These conditions include smoking-related interstitial lung diseases, metabolic disorders such as Niemann-Pick or Gaucher disease, and rare primary lung tumors. High-resolution computed tomography abnormalities include pulmonary ground-glass opacification secondary to infiltration by macrophages, centrilobular nodules or interlobular septal thickening reflecting peribronchiolar or septal macrophage accumulation, respectively, emphysema caused by macrophage dysfunction, and honey combing following macrophage-related lung matrix remodeling.
Monitoring of liver metastases after stereotactic radiotherapy using low-MI contrast-enhanced ultrasound: initial results Krix M, Plathow C, Essig M, Herfarth K, Debus J, Kauczor H-U, Delorme S (German Cancer Research Center-Radiology, Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany). Eur Radiol 2005;15:677– 684. The purpose of this study was to monitor liver metastases after radiotherapy using contrast-enhanced ultrasound (CEUS). In 15 patients, follow-up examinations after stereotactic, single-dose radiotherapy were performed using CEUS [low mechanical index (MI), 2.4-mil SonoVue] and computed tomography (CT). Besides tumor size, the enhancement of the liver and the metastases was assessed at the arterial, portal venous, and delayed phases. The sizes of the tumor and of a perifocal liver reaction after radiotherapy measured with CEUS significantly correlated with those measured at CT (r = .93, P b.001). CEUS found a significant reduction of the arterial vascularization in treated tumors ( P b.05). In the arterial phase, the perifocal liver tissue was hypervascularized compared with the treated tumor ( P b.001); in the late phase, it was less enhanced than the liver ( P b 0.001) and more than the tumor ( P b.01). The perifocal liver reaction was also seen in CT, but with a variable enhancement at the arterial (50% hyperdense compared with normal liver tissue), venous, or delayed phase (each with 70% hyperdense reactions). CEUS allows for the assessment of tumor and liver perfusion, in addition to morphological tumor examination, which was comparable with CT. Thus, changes of tumor perfusion, which may indicate tumor response, as well as the perifocal liver reaction after radiotherapy, which must be differentiated from perifocal tumor growth, can be sensitively visualized using CEUS.
Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern Jung SE, Lee JM, Rha SE, Choi BG, Kim EK, Hahn ST (Department of Radiology, St Mary’s Hospital, The Catholic University of Korea, #62, Yeouido-dong, Youngdeungpo-gu, Seoul, 150-713, South Korea). Eur Radiol 2005;15:694 –701. The aim of this study was to correlate the MR findings of gallbladder wall thickening with pathologic findings on the basis of the layered pattern and to evaluate the diagnostic value of MR imaging in gallbladder disease. We retrospectively evaluated the source images of HASTE sequences for MR cholangiography in 144 patients with gallbladder wall thickening. The layered pattern of thickened wall was classified into four patterns. Type 1 shows two layers with a thin hypointense inner layer and thick hyperintense
Abstracts / Journal of Clinical Imaging 29 (2005) 373–377
Cancer Agency, British Columbia, Canada, and reviews the literature on this topic. Using the database at PETSCAN Vancouver, we identified imaged patients with a diagnosis of breast cancer. We then conducted a retrospective review of these patients’ BC Cancer Agency charts to extract demographic and follow-up information. Between November 2000 and March 2003, we identified 165 patients with histologically confirmed breast cancer who had undergone PET scanning, were registered at the BC Cancer Agency, and had follow-up information. The median patient age was 52 years. The sensitivity of PET in detecting axillary metastases was 28%, and the specificity was 86%. At diagnosis, 5% of patients were diagnosed with distant metastases. In patients undergoing PET scanning because of suspected recurrence, the sensitivity and specificity for detecting recurrence were 89% and 88%, respectively. Distant metastases were demonstrated in 30% of patients who were thought only to have local–regional recurrence. The results suggest that there are two clinical situations in which PET appears to be particularly valuable. The first is in the evaluation of patients who are suspected of having a tumor recurrence. The other is in identifying patients with multifocal or distant sites of malignancy who otherwise appear to have an isolated, potentially curable, local–regional recurrence.
Multidetector computed tomography-guided treatment strategy in patients with non-ST elevation acute coronary syndromes: a pilot study Dorgelo J, Willems TP, Geluk CA, van Ooijen PMA, Zijlstra F, Oudkerk M (Department of Radiology, University Hospital Groningen, Groningen, The Netherlands). Eur Radiol 2005;15:708–713. Patients with non-ST elevation acute coronary syndrome (ACS) and evidence of myocardial ischaemia are scheduled for coronary angiography (CAG). In most patients, CAG remains a single diagnostic procedure only. A prospective study was performed to evaluate whether 16-slice multidetector CT (MDCT) could predict treatment of the patients and to determine how many CAGs could have been prevented by MDCT scanning prior to CAG. Twentytwo patients with ACS were scanned prior to CAG. Based on MDCT data, a fictive treatment was proposed and compared with a CAG-based treatment. Excellent accuracy was observed to detect significant stenoses using MDCT (sensitivity 94%, specificity 96%). In 45%, no PCI was performed during CAG because of the absence of significant coronary artery disease (27%) or severe coronary artery disease, demanding CABG (18%). MDCT predicted correct treatment in 86%. By using MDCT data, 32% of the CAGs could have been prevented.
In vivo 1H MR spectroscopy of thyroid carcinoma King AD, Yeung DKW, Ahuja AT, Tse GMK, Chan ABW, Lam SSL, van Hasselt AC (Department of Diagnostic Radiology and Organ Imaging, Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR China). Eur J Radiol 2005;54:112 –117. The aim of this study was to determine if proton magnetic resonance spectroscopy (1H MRS) of thyroid carcinoma is feasible and to determine if 1 H MRS spectra of malignant tumors differ from that of normal thyroid tissue. We performed 1H MRS at 1.5 T at echo times (TE) 136 and 272 ms to examine eight patients, with thyroid cancer (primary tumor or nodal metastasis) larger than 1 cm3 in size, and five volunteers with normal thyroids. Spectra acquired from six primary tumors (three anaplastic carcinomas, two papillary carcinomas, and one follicular carcinoma) and two nodes (two papillary carcinoma metastases) were analyzed in the time domain using a nonlinear least squares fitting algorithm with incorporation of prior knowledge. Choline (3.2 ppm) was identified in all solid carcinomas, with a mean choline/creatine of 4.3 at TE 136 ms and 5.4 at TE 272 ms. Ratios for malignant tumors at TE 136 ms ranged from 1.6 in well-differentiated follicular carcinoma to 9.4 in anaplastic carcinoma. No choline was detected in normal thyroid tissues. Our results showed that 1H
MRS is a feasible technique for the evaluation of malignant thyroid tumors larger than 1 cm3 and that proton spectra of malignant tumors differ from that of normal thyroid tissue.
Imaging of macrophage-related lung diseases Marten K, Hansell DM (Department of Radiology, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK). Eur Radiol 2005;15:727–741. Macrophage-related pulmonary diseases are a heterogeneous group of disorders characterized by macrophage accumulation, activation, or dysfunction. These conditions include smoking-related interstitial lung diseases, metabolic disorders such as Niemann-Pick or Gaucher disease, and rare primary lung tumors. High-resolution computed tomography abnormalities include pulmonary ground-glass opacification secondary to infiltration by macrophages, centrilobular nodules or interlobular septal thickening reflecting peribronchiolar or septal macrophage accumulation, respectively, emphysema caused by macrophage dysfunction, and honey combing following macrophage-related lung matrix remodeling.
Monitoring of liver metastases after stereotactic radiotherapy using low-MI contrast-enhanced ultrasound: initial results Krix M, Plathow C, Essig M, Herfarth K, Debus J, Kauczor H-U, Delorme S (German Cancer Research Center-Radiology, Im Neuenheimer Feld 280, D-69120 Heidelberg, Germany). Eur Radiol 2005;15:677– 684. The purpose of this study was to monitor liver metastases after radiotherapy using contrast-enhanced ultrasound (CEUS). In 15 patients, follow-up examinations after stereotactic, single-dose radiotherapy were performed using CEUS [low mechanical index (MI), 2.4-mil SonoVue] and computed tomography (CT). Besides tumor size, the enhancement of the liver and the metastases was assessed at the arterial, portal venous, and delayed phases. The sizes of the tumor and of a perifocal liver reaction after radiotherapy measured with CEUS significantly correlated with those measured at CT (r = .93, P b.001). CEUS found a significant reduction of the arterial vascularization in treated tumors ( P b.05). In the arterial phase, the perifocal liver tissue was hypervascularized compared with the treated tumor ( P b.001); in the late phase, it was less enhanced than the liver ( P b 0.001) and more than the tumor ( P b.01). The perifocal liver reaction was also seen in CT, but with a variable enhancement at the arterial (50% hyperdense compared with normal liver tissue), venous, or delayed phase (each with 70% hyperdense reactions). CEUS allows for the assessment of tumor and liver perfusion, in addition to morphological tumor examination, which was comparable with CT. Thus, changes of tumor perfusion, which may indicate tumor response, as well as the perifocal liver reaction after radiotherapy, which must be differentiated from perifocal tumor growth, can be sensitively visualized using CEUS.
Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern Jung SE, Lee JM, Rha SE, Choi BG, Kim EK, Hahn ST (Department of Radiology, St Mary’s Hospital, The Catholic University of Korea, #62, Yeouido-dong, Youngdeungpo-gu, Seoul, 150-713, South Korea). Eur Radiol 2005;15:694 –701. The aim of this study was to correlate the MR findings of gallbladder wall thickening with pathologic findings on the basis of the layered pattern and to evaluate the diagnostic value of MR imaging in gallbladder disease. We retrospectively evaluated the source images of HASTE sequences for MR cholangiography in 144 patients with gallbladder wall thickening. The layered pattern of thickened wall was classified into four patterns. Type 1 shows two layers with a thin hypointense inner layer and thick hyperintense