Diagnostics

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15 pages, 8257 KiB

Open AccessArticle

Evaluation of Whole Brain Intravoxel Incoherent Motion (IVIM) Imaging

by Kamil Lipiński and Piotr Bogorodzki

Diagnostics 2024, 14(6), 653; https://doi.org/10.3390/diagnostics14060653 - 20 Mar 2024

Viewed by 552

Abstract

Intravoxel Incoherent Motion (IVIM) imaging provides non-invasive perfusion measurements, eliminating the need for contrast agents. This work explores the feasibility of IVIM imaging in whole brain perfusion studies, where an isotropic 1 mm voxel is widely accepted as a standard. This study follows [...] Read more.

Intravoxel Incoherent Motion (IVIM) imaging provides non-invasive perfusion measurements, eliminating the need for contrast agents. This work explores the feasibility of IVIM imaging in whole brain perfusion studies, where an isotropic 1 mm voxel is widely accepted as a standard. This study follows the validity of a time-limited, precise, segmentation-ready whole-brain IVIM protocol suitable for clinical reality. To assess the influence of SNR on the estimation of S₀, f, D*, and D IVIM parameters, a series of measurements and simulations were performed in MATLAB for the following three estimation techniques: segmented grid search, segmented curve fitting, and one-step curve fitting, utilizing known “ground truth” and noised data. Scanner-specific SNR was estimated based on a healthy subject IVIM MRI study in a 3T scanner. Measurements were conducted for 25.6 × 25.6 × 14.4 cm FOV with a 256 × 256 in-plane resolution and 72 slices, resulting in 1 × 1 × 2 mm voxel size. Simulations were performed for 36 SNR levels around the measured SNR value. For a single voxel grid, the search algorithm mean relative error Ŝ₀,

\hat{f}

,

{\hat{D}}^{*}

, and

\hat{D}

of at the expected SNR level were 5.00%, 81.91%, 76.31%, and 18.34%, respectively. Analysis has shown that high-resolution IVIM imaging is possible, although there is significant variation in both accuracy and precision, depending on SNR and the chosen estimation method. Full article

(This article belongs to the Special Issue Advanced MRI in Clinical Diagnosis)

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12 pages, 2777 KiB

Open AccessArticle

Cardiac Magnetic Resonance Imaging Based Ischemic Injury Pattern in Patients with Acute Myocardial Infarction Sensu Left Ventricular Global Systolic Function

by Lyudmila Salyamova, Valentin Oleynikov, Natalia Donetskaya, Alexander Vdovkin, Angelina Chernova and Irina Avdeeva

Diagnostics 2024, 14(6), 588; https://doi.org/10.3390/diagnostics14060588 - 11 Mar 2024

Viewed by 511

Abstract

The purpose of the study was to identify factors characterizing a decrease in LV global systolic function in patients with ST-segment elevation myocardial infarction (STEMI) after revascularization using cardiac magnetic resonance imaging (MRI)-based ischemic injury pattern and laboratory parameters sensu left ventricular global [...] Read more.

The purpose of the study was to identify factors characterizing a decrease in LV global systolic function in patients with ST-segment elevation myocardial infarction (STEMI) after revascularization using cardiac magnetic resonance imaging (MRI)-based ischemic injury pattern and laboratory parameters sensu left ventricular global systolic function. A total of 109 STEMI patients were examined. The patients underwent contrast-enhanced cardiac MRI with a 1.5 Tesla GE SIGNA Voyager (GE HealthCare, Chicago, IL, USA) on the 7th–10th days from the onset of the disease. According to cardiac MRI analysis, the patients were divided into the following groups with regard to left ventricular ejection fraction (LVEF) values: Group 1—patients with LVEF ≥ 50%; group 2—patients with mildly reduced LVEF 40–49%; group 3—patients with low LVEF < 40%. A predominance of most parameters of the ischemic injury pattern was noted in patients with mildly reduced and low LVEF versus patient group with LVEF ≥ 50%. Some risk factors for a decrease in LVEF < 50% systolic function in STEMI patients after revascularization were revealed: male gender; time from the onset of the anginal attack to revascularization; coronary artery status; several LV parameters; ischemic injury characteristics; natriuretic peptide and troponin I levels. Full article

(This article belongs to the Special Issue Advanced MRI in Clinical Diagnosis)

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11 pages, 857 KiB

Open AccessArticle

Limited Role of the Apparent Diffusion Coefficient (ADC) for Tumor Grade and Overall Survival in Resectable Pancreatic Ductal Adenocarcinoma

by Deniece M. Riviere, Marnix C. Maas, Lodewijk A. A. Brosens, Martijn W. J. Stommel, Cornelis J. H. M. van Laarhoven and John J. Hermans

Diagnostics 2024, 14(6), 573; https://doi.org/10.3390/diagnostics14060573 - 07 Mar 2024

Viewed by 541

Abstract

This study evaluated the relationship between apparent diffusion coefficient (ADC) values in pancreatic ductal adenocarcinoma (PDAC) and tumor grades based on WHO, Adsay, and Kalimuthu classifications, using whole-mount pancreatectomy specimens. If glandular formation plays a key role in the degree of diffusion restriction, [...] Read more.

This study evaluated the relationship between apparent diffusion coefficient (ADC) values in pancreatic ductal adenocarcinoma (PDAC) and tumor grades based on WHO, Adsay, and Kalimuthu classifications, using whole-mount pancreatectomy specimens. If glandular formation plays a key role in the degree of diffusion restriction, diffusion-weighted imaging could facilitate non-invasive grading of PDAC. A freehand region of interest (ROI) was drawn along tumor borders on the preoperative ADC map in each tumor-containing slice. Resection specimens were retrospectively graded according to WHO, Adsay, and Kalimuthu classifications and correlated with overall survival and the 10th percentile of whole-volume ADC values. Findings from 40 patients (23 male, median age 67) showed no correlation between ADC p10 values and WHO differentiation (p = 0.050), Adsay grade (p = 0.955), or Kalimuthu patterns (p = 0.117). There was no association between ADC p10 and overall survival (p = 0.082) and other clinicopathological variables. Survival was significantly lower for poor tumor differentiation (p = 0.046) and non-glandular Kalimuthu patterns (p = 0.016) and there was a trend towards inferior survival for Adsay G3 (p = 0.090) after correction for age, tumor location, and stage. Preoperative ADC measurements for determining PDAC aggressiveness had limited clinical utility, as there was no correlation with histological parameters or overall survival in resectable PDAC. Full article

(This article belongs to the Special Issue Advanced MRI in Clinical Diagnosis)

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14 pages, 2100 KiB

Open AccessArticle

A Comparative Evaluation of Multiparametric Magnetic Resonance Imaging and Micro-Ultrasound for the Detection of Clinically Significant Prostate Cancer in Patients with Prior Negative Biopsies

by Edoardo Beatrici, Nicola Frego, Giuseppe Chiarelli, Federica Sordelli, Stefano Mancon, Cesare Saitta, Fabio De Carne, Giuseppe Garofano, Paola Arena, Pier Paolo Avolio, Andrea Gobbo, Alessandro Uleri, Roberto Contieri, Marco Paciotti, Massimo Lazzeri, Rodolfo Hurle, Paolo Casale, Nicolò Maria Buffi and Giovanni Lughezzani

Diagnostics 2024, 14(5), 525; https://doi.org/10.3390/diagnostics14050525 - 01 Mar 2024

Viewed by 691

Abstract

Background: The diagnostic process for prostate cancer after a negative biopsy is challenging. This study compares the diagnostic accuracy of micro-ultrasound (mUS) with multiparametric magnetic resonance imaging (mpMRI) for such cases. Methods: A retrospective cohort study was performed, targeting men with previous negative [...] Read more.

Background: The diagnostic process for prostate cancer after a negative biopsy is challenging. This study compares the diagnostic accuracy of micro-ultrasound (mUS) with multiparametric magnetic resonance imaging (mpMRI) for such cases. Methods: A retrospective cohort study was performed, targeting men with previous negative biopsies and using mUS and mpMRI to detect prostate cancer and clinically significant prostate cancer (csPCa). Results: In our cohort of 1397 men, 304 had a history of negative biopsies. mUS was more sensitive than mpMRI, with better predictive value for negative results. Importantly, mUS was significantly associated with csPCa detection (adjusted odds ratio [aOR]: 6.58; 95% confidence interval [CI]: 1.15–37.8; p = 0.035). Conclusions: mUS may be preferable for diagnosing prostate cancer in previously biopsy-negative patients. However, the retrospective design of this study at a single institution suggests that further research across multiple centers is warranted. Full article

(This article belongs to the Special Issue Advanced MRI in Clinical Diagnosis)

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16 pages, 3895 KiB

Open AccessArticle

Establishing Normative Values for Acromion Anatomy: A Comprehensive MRI-Based Study in a Healthy Population of 996 Participants

by Anne Prietzel, Theo Languth, Robin Bülow, Till Ittermann, René Laqua, Lyubomir Haralambiev, Georgi Iwan Wassilew, Axel Ekkernkamp and Mustafa Sinan Bakir

Diagnostics 2024, 14(1), 107; https://doi.org/10.3390/diagnostics14010107 - 03 Jan 2024

Viewed by 663

Abstract

Shoulder pain is a common issue often linked to conditions such as subacromial impingement or rotator cuff lesions. The role of the acromion in these symptoms remains a subject of debate. This study aims to establish standardized values for commonly used acromion dimensions [...] Read more.

Shoulder pain is a common issue often linked to conditions such as subacromial impingement or rotator cuff lesions. The role of the acromion in these symptoms remains a subject of debate. This study aims to establish standardized values for commonly used acromion dimensions based on whole-body MRI scans of a large and healthy population and to investigate potential correlations between acromion shape and influencing factors such as sex, age, BMI, dominant hand, and shoulder pain. The study used whole-body MRI scans from the Study of Health in Pomerania, a German population-based study. Acromion index, acromion tilt, and acromion slope were measured. Interrater variability was tested with two independent, trained viewers on 100 MRI sequences before actual measurements started. Descriptive statistics and logistic regression were used to evaluate the results. We could define reference values based on a shoulder-healthy population for each acromion parameter within the 2.5 to 97.5 percentile. No significant differences were found in acromion slope, tilt, and index between male and female participants. No significant correlations were observed between acromion morphology and anthropometric parameters such as height, weight, or BMI. No significant differences were observed in acromion parameters between dominant and non-dominant hands or stated pain intensity. This study provides valuable reference values for acromion-related parameters, offering insight into the anatomy of a healthy shoulder. The findings indicate no significant differences in acromion morphology based on sex, weight, BMI, or dominant hand. Further research is necessary to ascertain the clinical implications of these reference values. The establishment of standardized reference values opens new possibilities for enhancing clinical decision making regarding surgical interventions, such as acromioplasty. Full article

(This article belongs to the Special Issue Advanced MRI in Clinical Diagnosis)

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12 pages, 1680 KiB

Open AccessArticle

Characteristic Mean Kurtosis Values in Simple Diffusion Kurtosis Imaging of Dentigerous Cysts

by Yuka Fukumura, Masahiro Kuroda, Suzuka Yoshida, Yoshihide Nakamura, Yuki Nakamitsu, Wlla E. Al-Hammad, Kazuhiro Kuroda, Ryo Kamizaki, Yudai Shimizu, Yoshinori Tanabe, Kohei Sugimoto, Masataka Oita, Irfan Sugianto, Majd Barham, Nouha Tekiki, Nurul N. Kamaruddin, Yoshinobu Yanagi and Junichi Asaumi

Diagnostics 2023, 13(24), 3619; https://doi.org/10.3390/diagnostics13243619 - 07 Dec 2023

Cited by 2 | Viewed by 764

Abstract

We evaluated the usefulness of simple diffusion kurtosis (SD) imaging, which was developed to generate diffusion kurtosis images simultaneously with an apparent diffusion coefficient (ADC) map for 27 cystic disease lesions in the head and neck region. The mean kurtosis (MK) and ADC [...] Read more.

We evaluated the usefulness of simple diffusion kurtosis (SD) imaging, which was developed to generate diffusion kurtosis images simultaneously with an apparent diffusion coefficient (ADC) map for 27 cystic disease lesions in the head and neck region. The mean kurtosis (MK) and ADC values were calculated for the cystic space. The MK values were dentigerous cyst (DC): 0.74, odontogenic keratocyst (OKC): 0.86, ranula (R): 0.13, and mucous cyst (M): 0, and the ADC values were DC: 1364 × 10⁻⁶ mm²/s, OKC: 925 × 10⁻⁶ mm²/s, R: 2718 × 10⁻⁶ mm²/s, and M: 2686 × 10⁻⁶ mm²/s. The MK values of DC and OKC were significantly higher than those of R and M, whereas their ADC values were significantly lower. One reason for the characteristic signal values in diffusion-weighted images of DC may be related to content components such as fibrous tissue and exudate cells. When imaging cystic disease in the head and neck region using SD imaging, the maximum b-value setting at the time of imaging should be limited to approximately 1200 s/mm² for accurate MK value calculation. This study is the first to show that the MK values of DC are characteristically higher than those of other cysts. Full article

(This article belongs to the Special Issue Advanced MRI in Clinical Diagnosis)

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13 pages, 11370 KiB

Open AccessArticle

Patello-Femoral Pain Syndrome: Magnetic Resonance Imaging versus Ultrasound

by Patrizia Pacini, Milvia Martino, Luca Giuliani, Gabriele Santilli, Francesco Agostini, Giovanni Del Gaudio, Andrea Bernetti, Massimiliano Mangone, Marco Paoloni, Martina Toscano, Corrado De Vito, Carlo Ottonello, Valter Santilli and Vito Cantisani

Diagnostics 2023, 13(8), 1496; https://doi.org/10.3390/diagnostics13081496 - 21 Apr 2023

Viewed by 2957

Abstract

Background: Magnetic Resonance Imaging (MRI) and Ultrasound (US) in combination with clinical data could contribute to the diagnosis, staging and follow-up of Patello-Femoral Syndrome (PFS), which often overlaps with other pathologies of the knee. Purpose of the Study: To evaluate the diagnostic role [...] Read more.

Background: Magnetic Resonance Imaging (MRI) and Ultrasound (US) in combination with clinical data could contribute to the diagnosis, staging and follow-up of Patello-Femoral Syndrome (PFS), which often overlaps with other pathologies of the knee. Purpose of the Study: To evaluate the diagnostic role of MRI and US findings associated with PFS and define the range values of instrumental measurements obtained in pathological cases and healthy controls, the performance of the two methods in comparison, and the correlation with clinical data. Materials and Methods: 100 subjects were examined: 60 patients with a high suspicion of PFS at the clinical evaluation and 40 healthy controls. All measurements obtained by MRI and US examination were correlated with clinical data. A descriptive analysis of all measurements was stratified for pathological cases and healthy controls. A Student’s t-test for continuous variables was used to compare patients to controls and US to MRI. Logistic regression analysis was applied to test the correlation between MRI and US measurements with clinical data. Results: Statistical descriptive analysis determined the MRI and US range values of medial patello-femoral distance and the thickness of retinacles and cartilages in pathological cases and healthy controls. In pathological cases, the retinacle results of both increased; the medial appeared to be slightly more increased than the lateral. Furthermore, in some cases, the thickness of the cartilage decreased in both techniques; the medial cartilage was more thinned than the lateral. According to logistic regression analyses, the best diagnostic parameter was the medial patello-femoral distance due to the overlapping results of the US and MRI. Furthermore, all clinical data obtained by different tests showed a good correlation with patello-femoral distance. In particular, the correlation between medial patello-femoral distance and the VAS score is direct and equal to 97–99%, which is statistically significant (p < 0.001), and the correlation with the KOOS score is inverse and equal to 96–98%, which is statistically significant. Conclusions: MRI and Ultrasound examination in combination with clinical data demonstrated high-value results in the diagnosis of PFS. Full article

(This article belongs to the Special Issue Advanced MRI in Clinical Diagnosis)

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13 pages, 287 KiB

Open AccessArticle

White Matter Lesions Identified by Magnetic Resonance in Women with Migraine: A Volumetric Analysis and Clinical Correlations

by Natália de Oliveira Silva, Nicoly Machado Maciel, Júlio César Nather, Jr., Gabriela Ferreira Carvalho, Carina Ferreira Pinheiro, Marcelo Eduardo Bigal, Antônio Carlos dos Santos, Debora Bevilaqua-Grossi and Fabiola Dach

Diagnostics 2023, 13(4), 799; https://doi.org/10.3390/diagnostics13040799 - 20 Feb 2023

Viewed by 1234

Abstract

Background: Repeated migraine attacks and aura could independently cause structural changes in the central nervous system. Our research aims to study the correlation of migraine type, attack frequency, and other clinical variables with the presence, volume and localization of white matter lesions (WML), [...] Read more.

Background: Repeated migraine attacks and aura could independently cause structural changes in the central nervous system. Our research aims to study the correlation of migraine type, attack frequency, and other clinical variables with the presence, volume and localization of white matter lesions (WML), in a controlled study. Methods: Sixty volunteers from a tertiary headache center were selected and divided equally into four groups: episodic migraine without aura (MoA), episodic migraine with aura (MA), chronic migraine (CM) and controls (CG). Voxel-based morphometry techniques were used to analyze WML. Results: There were no differences in WML variables between groups. There was a positive correlation between age and the number and total volume of WMLs, which persisted in the comparison categorized by size and brain lobe. Disease duration was positively correlated with the number and total volume of WML, and when controlled by age, the correlation maintained significance only for the insular lobe. Aura frequency was associated with frontal and temporal lobe WMLs. There was no statistically significant correlation between WML and other clinical variables. Conclusion: Migraine overall is not a risk factor for WML. Aura frequency is, however, associated with temporal WML. Disease duration, in adjusted analyses that account for age, is associated with insular WML. Full article

(This article belongs to the Special Issue Advanced MRI in Clinical Diagnosis)

15 pages, 11105 KiB

Open AccessArticle

The Influence of Surgical Realignment Procedures on Dynamic Patellar Tracking: A Dynamic Magnetic Resonance Imaging-Controlled Feasibility Study

by Jannik Frings, Tobias Dust, Jennifer Meyer, Matthias Krause, Karl-Heinz Frosch, Gerhard Adam, Frank Oliver Henes, Clemens Spink and Kai-Jonathan Maas

Diagnostics 2022, 12(11), 2761; https://doi.org/10.3390/diagnostics12112761 - 11 Nov 2022

Cited by 2 | Viewed by 1553

Abstract

Persisting patellar maltracking following surgical realignment often remains unseen. The aim of this study was to analyze the effects of realignment procedures on patellofemoral kinematics in patients with patellofemoral instability (PFI) and patellofemoral maltracking (PM) by using dynamic magnetic resonance imaging (MRI). Patients [...] Read more.

Persisting patellar maltracking following surgical realignment often remains unseen. The aim of this study was to analyze the effects of realignment procedures on patellofemoral kinematics in patients with patellofemoral instability (PFI) and patellofemoral maltracking (PM) by using dynamic magnetic resonance imaging (MRI). Patients planned for surgical patellar realignment due to PFI and a clinically and radiologically apparent PM between December 2019 and May 2022 were included. Patients without PM, limited range of motion, joint effusion, or concomitant injuries were excluded. Dynamic mediolateral translation (dMPT) and patella tilt (dPT) were measured preoperatively and three months postoperatively. In 24 patients (7 men, 17 women; mean age 23.0 years), 10 tibial tubercle transfers, 5 soft tissue patella tendon transfers, 6 trochleoplasties, 3 lateral lengthenings, 1 varizating distal femoral osteotomy (DFO), and 1 torsional DFO were performed. At final follow-up, dMPT (from 10.95 ± 5.93 mm to 4.89 ± 0.40 mm, p < 0.001) and dPT (from 14.50° ± 10.33° to 8.44° ± 7.46°, p = 0.026) were significantly improved. All static radiological parameters were corrected to physiological values. Surgical patellar realignment contributed to the significant improvement of patellofemoral kinematics, with an approximation to normal values. The postoperative application of dynamic MRI allowed for a quantification of the performed correction, allowing for a postoperative control of success. Full article

(This article belongs to the Special Issue Advanced MRI in Clinical Diagnosis)

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15 pages, 2623 KiB

Open AccessArticle

Classification Scheme of Heating Risk during MRI Scans on Patients with Orthopaedic Prostheses

by Valeria Clementi, Umberto Zanovello, Alessandro Arduino, Cristina Ancarani, Fabio Baruffaldi, Barbara Bordini, Mario Chiampi, Luca Zilberti and Oriano Bottauscio

Diagnostics 2022, 12(8), 1873; https://doi.org/10.3390/diagnostics12081873 - 02 Aug 2022

Cited by 4 | Viewed by 1638

Abstract

Due to the large variety of possible clinical scenarios, a reliable heating-risk assessment is not straightforward when patients with arthroplasty undergo MRI scans. This paper proposes a simple procedure to estimate the thermal effects induced in patients with hip, knee, or shoulder arthroplasty [...] Read more.

Due to the large variety of possible clinical scenarios, a reliable heating-risk assessment is not straightforward when patients with arthroplasty undergo MRI scans. This paper proposes a simple procedure to estimate the thermal effects induced in patients with hip, knee, or shoulder arthroplasty during MRI exams. The most representative clinical scenarios were identified by a preliminary frequency analysis, based on clinical service databases, collecting MRI exams of 11,658 implant carrier patients. The thermal effects produced by radiofrequency and switching gradient fields were investigated through 588 numerical simulations performed on an ASTM-like phantom, considering four prostheses, two static field values, seven MR sequences, and seven regions of imaging. The risk assessment was inspired by standards for radiofrequency fields and by scientific studies for gradient fields. Three risk tiers were defined for the radiofrequency, in terms of whole-body and local SAR averages, and for GC fields, in terms of temperature elevation. Only 50 out of 588 scenarios require some caution to be managed. Results showed that the whole-body SAR is not a self-reliant safety parameter for patients with metallic implants. The proposed numerical procedure can be easily extended to any other scenario, including the use of detailed anatomical models. Full article

(This article belongs to the Special Issue Advanced MRI in Clinical Diagnosis)

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Review

Jump to: Research, Other

19 pages, 2154 KiB

Open AccessReview

Magnetic Resonance Imaging of the Gastrointestinal Tract: Current Role, Recent Advancements and Future Prospectives

by Francesca Maccioni, Ludovica Busato, Alessandra Valenti, Sara Cardaccio, Alessandro Longhi and Carlo Catalano

Diagnostics 2023, 13(14), 2410; https://doi.org/10.3390/diagnostics13142410 - 19 Jul 2023

Cited by 1 | Viewed by 3860

Abstract

This review focuses on the role of magnetic resonance imaging (MRI) in the evaluation of the gastrointestinal tract (GI MRI), analyzing the major technical advances achieved in this field, such as diffusion-weighted imaging, molecular imaging, motility studies, and artificial intelligence. Today, MRI performed [...] Read more.

This review focuses on the role of magnetic resonance imaging (MRI) in the evaluation of the gastrointestinal tract (GI MRI), analyzing the major technical advances achieved in this field, such as diffusion-weighted imaging, molecular imaging, motility studies, and artificial intelligence. Today, MRI performed with the more advanced imaging techniques allows accurate assessment of many bowel diseases, particularly inflammatory bowel disease and rectal cancer; in most of these diseases, MRI is invaluable for diagnosis, staging, and disease monitoring under treatment. Several MRI parameters are currently considered activity biomarkers for inflammation and neoplastic disease. Furthermore, in younger patients with acute or chronic GI disease, MRI can be safely used for short-term follow-up studies in many critical clinical situations because it is radiation-free. MRI assessment of functional gastro-esophageal and small bowel disorders is still in its infancy but very promising, while it is well established and widely used for dynamic assessment of anorectal and pelvic floor dysfunction; MRI motility biomarkers have also been described. There are still some limitations to GI MRI related to high cost and limited accessibility. However, technical advances are expected, such as faster sequences, more specific intestinal contrast agents, AI analysis of MRI data, and possibly increased accessibility to GI MRI studies. Clinical interest in the evaluation of bowel disease using MRI is already very high, but is expected to increase significantly in the coming years. Full article

(This article belongs to the Special Issue Advanced MRI in Clinical Diagnosis)

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11 pages, 1794 KiB

Open AccessReview

Local Recurrences in Rectal Cancer: MRI vs. CT

by Giulia Grazzini, Ginevra Danti, Giuditta Chiti, Caterina Giannessi, Silvia Pradella and Vittorio Miele

Diagnostics 2023, 13(12), 2104; https://doi.org/10.3390/diagnostics13122104 - 17 Jun 2023

Cited by 1 | Viewed by 1944

Abstract

Rectal cancers are often considered a distinct disease from colon cancers as their survival and management are different. Particularly, the risk for local recurrence (LR) is greater than in colon cancer. There are many factors predisposing to LR such as postoperative histopathological features [...] Read more.

Rectal cancers are often considered a distinct disease from colon cancers as their survival and management are different. Particularly, the risk for local recurrence (LR) is greater than in colon cancer. There are many factors predisposing to LR such as postoperative histopathological features or the mesorectal plane of surgical resection. In addition, the pattern of LR in rectal cancer has a prognostic significance and an important role in the choice of operative approach and. Therefore, an optimal follow up based on imaging is critical in rectal cancer. The aim of this review is to analyse the risk and the pattern of local recurrences in rectal cancer and to provide an overview of the role of imaging in early detection of LRs. We performed a literature review of studies published on Web of Science and MEDLINE up to January 2023. We also reviewed the current guidelines of National Comprehensive Cancer Network (NCCN) and the European Society for Medical Oncology (ESMO). Although the timing and the modality of follow-up is not yet established, the guidelines usually recommend a time frame of 5 years post surgical resection of the rectum. Computed Tomography (CT) scans and/or Magnetic Resonance Imaging (MRI) are the main imaging techniques recommended in the follow-up of these patients. PET-CT is not recommended by guidelines during post-operative surveillance and it is generally used for problem solving. Full article

(This article belongs to the Special Issue Advanced MRI in Clinical Diagnosis)

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Other

Jump to: Research, Review

11 pages, 1917 KiB

Open AccessProtocol

Magnetic Resonance Imaging Evaluation of Bone Metastases Treated with Radiotherapy in Palliative Intent: A Multicenter Prospective Study on Clinical and Instrumental Evaluation Assessment Concordance (MARTE Study)

by Alfonso Reginelli, Vittorio Patanè, Fabrizio Urraro, Anna Russo, Marco De Chiara, Alfredo Clemente, Umberto Atripaldi, Giovanni Balestrucci, Mauro Buono, Emma D’ippolito, Roberta Grassi, Ida D’onofrio, Stefania Napolitano, Teresa Troiani, Ferdinando De Vita, Fortunato Ciardiello, Valerio Nardone and Salvatore Cappabianca

Diagnostics 2023, 13(14), 2334; https://doi.org/10.3390/diagnostics13142334 - 10 Jul 2023

Cited by 1 | Viewed by 3092

Abstract

Metastasis to bone is a common occurrence among epithelial tumors, with a high incidence rate in the Western world. As a result, bone lesions are a significant burden on the healthcare system, with a high morbidity index. These injuries are often symptomatic and [...] Read more.

Metastasis to bone is a common occurrence among epithelial tumors, with a high incidence rate in the Western world. As a result, bone lesions are a significant burden on the healthcare system, with a high morbidity index. These injuries are often symptomatic and can lead to functional limitations, which in turn cause reduced mobility in patients. Additionally, they can lead to secondary complications such as pathological fractures, spinal cord compression, hypercalcemia, or bone marrow suppression. The treatment of bone metastases requires collaboration between multiple healthcare professionals, including oncologists, orthopedists, neurosurgeons, physiatrists, and radiotherapists. The primary objective of this study is to evaluate the correlation between two methods used to assess local control. Specifically, the study aims to determine if a reduction in the volume of bone lesions corresponds to better symptomatic control in the clinical management of patients, and vice versa. To achieve this objective, the study evaluates morphological criteria by comparing pre- and post-radiotherapy treatment imaging using MRI and RECIST 1.1 criteria. MRI without contrast is the preferred diagnostic imaging method, due to its excellent tolerance by patients, the absence of exposure to ionizing radiation, and the avoidance of paramagnetic contrast media side effects. This imaging modality allows for accurate assessment of bone lesions. One of the secondary objectives of this study is to identify potentially useful parameters that can distinguish patients into two classes: “good” and “poor” responders to treatment, as reported by previous studies in the literature. These parameters can be evaluated from the imaging examinations by analyzing morphological changes and radiomic features on different sequences, such as T1, STIR (short tau inversion recovery), and DWI-MRI (diffusion-weighted). Full article

(This article belongs to the Special Issue Advanced MRI in Clinical Diagnosis)

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14 pages, 11409 KiB

Open AccessTechnical Note

MRI-Cavernosography: A New Diagnostic Tool for Erectile Dysfunction Due to Venous Leakage: A Diagnostic Chance

by Marco Di Serafino, Luigi Pucci, Francesca Iacobellis, Marco Fasbender Jacobitti, Roberto Ronza, Vittorio Sabatino, Luigi De Luca, Vincenzo Iossa, Nunzio Alberto Langella, Francesco Persico, Dario Grimaldi, Maria Laura Schillirò, Luca Lessoni, Maurizio Notorio, Maurizio Carrino and Luigia Romano

Diagnostics 2023, 13(13), 2178; https://doi.org/10.3390/diagnostics13132178 - 26 Jun 2023

Cited by 1 | Viewed by 3435

Abstract

Erectile dysfunction caused by venous leakage is a vascular disease in which blood fails to accumulate in the corpora cavernosa due to the abrupt drainage of blood from the penis secondary to an abnormal venous network that affects 1 to 2% of men [...] Read more.

Erectile dysfunction caused by venous leakage is a vascular disease in which blood fails to accumulate in the corpora cavernosa due to the abrupt drainage of blood from the penis secondary to an abnormal venous network that affects 1 to 2% of men under 25 years old and about 10 to 20% over 60 years old, who do not raise a sufficient erection for penetrative sex. The study of the venous leak and its characterization in young patients with erectile dysfunction represent a diagnostic challenge, and imaging remains the best way to diagnose this condition. In the article, it is described the methods of execution and the diagnostic role of the cavernous MRI in the study of vasogenic erectile dysfunction from the venous leak, proposing it as a good alternative to the cavernous CT, considering the satisfactory results in terms of diagnostic interpretation, the absence of ionizing radiation, the higher soft tissue resolution of the imaging method and the lower administration of contrast agent. Full article

(This article belongs to the Special Issue Advanced MRI in Clinical Diagnosis)

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10 pages, 1159 KiB

Open AccessStudy Protocol

CARdioimaging in Lung Cancer PatiEnts Undergoing Radical RadioTherapy: CARE-RT Trial

by Valerio Nardone, Maria Paola Belfiore, Marco De Chiara, Giuseppina De Marco, Vittorio Patanè, Giovanni Balestrucci, Mauro Buono, Maria Salvarezza, Gaetano Di Guida, Domenico D’Angiolella, Roberta Grassi, Ida D’Onofrio, Giovanni Cimmino, Carminia Maria Della Corte, Antonio Gambardella, Floriana Morgillo, Fortunato Ciardiello, Alfonso Reginelli and Salvatore Cappabianca

Diagnostics 2023, 13(10), 1717; https://doi.org/10.3390/diagnostics13101717 - 12 May 2023

Cited by 3 | Viewed by 1423

Abstract

Background: Non-small-cell lung cancer (NSCLC) is a common, steady growing lung tumour that is often discovered when a surgical approach is forbidden. For locally advanced inoperable NSCLC, the clinical approach consists of a combination of chemotherapy and radiotherapy, eventually followed by adjuvant immunotherapy, [...] Read more.

Background: Non-small-cell lung cancer (NSCLC) is a common, steady growing lung tumour that is often discovered when a surgical approach is forbidden. For locally advanced inoperable NSCLC, the clinical approach consists of a combination of chemotherapy and radiotherapy, eventually followed by adjuvant immunotherapy, a treatment that is useful but may cause several mild and severe adverse effect. Chest radiotherapy, specifically, may affect the heart and coronary artery, impairing heart function and causing pathologic changes in myocardial tissues. The aim of this study is to evaluate the damage coming from these therapies with the aid of cardiac imaging. Methods: This is a single-centre, prospective clinical trial. Patients with NSCLC who are enrolled will undergo computed tomography (CT) and magnetic resonance imaging (MRI) before chemotherapy 3 months, 6 months, and 9–12 months after the treatment. We expect to enrol 30 patients in 2 years. Conclusions: Our clinical trial will be an opportunity not only to highlight the timing and the radiation dose needed for pathological cardiac tissue changes to happen but will also provide useful data to set new follow-up schedules and strategies, keeping in mind that, more often than not, patients affected by NSCLC may present other heart- and lung-related pathological conditions. Full article

(This article belongs to the Special Issue Advanced MRI in Clinical Diagnosis)

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Open AccessCase Report

Giant Tumefactive Perivascular Space: Advanced Fusion MR Imaging and Tractography Study—A Case Report and a Systematic Review

by Renata Conforti, Raffaella Capasso, Donatella Franco, Carmela Russo, Fabio Oreste Rinaldi, Giovanna Pezzullo, Simone Coluccino, Maria Chiara Brunese, Corrado Caiazzo, Ferdinando Caranci and Fabio Tortora

Diagnostics 2023, 13(9), 1602; https://doi.org/10.3390/diagnostics13091602 - 30 Apr 2023

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Abstract

Perivascular spaces (PVSs) are small extensions of the subpial cerebrospinal space, pial-lined and interstitial fluid-filled. They surround small penetrating arteries, and veins, crossing the subarachnoid space to the brain tissue. Magnetic Resonance Imaging (MRI) shows a PVS as a round-shape or linear structure, [...] Read more.

Perivascular spaces (PVSs) are small extensions of the subpial cerebrospinal space, pial-lined and interstitial fluid-filled. They surround small penetrating arteries, and veins, crossing the subarachnoid space to the brain tissue. Magnetic Resonance Imaging (MRI) shows a PVS as a round-shape or linear structure, isointense to the cerebrospinal fluid, and, if larger than 1.5 cm, they are known as giant/tumefactive PVSs (GTPVS) that may compress neighboring parenchymal/liquoral compartment. We report a rare asymptomatic case of GTPVS type 1 in a diabetic middle-aged patient, occasionally discovered. Our MRI study focuses on diffusion/tractography and fusion imaging: three-dimensional (3D) constructive interference in steady state (CISS) and time of fly (TOF) sequences. The advanced and fusion MR techniques help us to track brain fiber to assess brain tissue compression consequences and some PVS anatomic features as the perforating arteries inside them. Full article

(This article belongs to the Special Issue Advanced MRI in Clinical Diagnosis)

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