Navigator respiratory-triggered diffusion-weighted imaging in the follow-up after hepatic radiofrequency ablation-initial results

Abstract Background Vertebral collapse is a common problem due to benign conditions (trauma, infection, osteoporosis) or malignant process. And although the spine is the most common site of bone metastases (39% of bony metastases in patients with primary neoplasms) benign vertebral fractures due to osteopenia occur in one third of cancer patients, making it essential to determine whether the cause of vertebral collapse is benign or malignant. Aim of the Work To establish the role of DWI in differentiating benign from pathologic vertebral fractures using ADC values in comparison with histopathology report /laboratory evaluation and clinical follow-up. Patients and Methods A cross sectional study is approved by the ethics review board of Ain Shams University Hospital (Al Demerdash). All patients provided informed consent for the MR imaging examinations and for inclusion of their data in this analysis. From April 2020 to october 2020, 25 cases with previous imaging with vertebral compression underwent conventional MRI study on the affected region. Diffusion weighted imaging and ADC was added. Results We performed DWI using maximum b-values 600, and quantitative analysis, named apparent diffusion coefficient (ADC). We correlated the ADC number to histopathology, laboratory finding and clinical follow up. In our study there was significant difference (p < 0.04) between DWI of the benign and malignant groups. Also the ADC value showed significant difference <0.001. The mean ADCs of benign VCFs were higher significantly than those of pathological fractures. Conclusion DWI with ADC value was helpful when added to conventional MRI to differentiate benign from pathological (malignant) vertebral compression. It should be a routine sequence in patients with vertebral compression fractures for accurate diagnosis and successful management also can decrease no of biopsies.

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Diffusion imaging of cerebral diaschisis in childhood arterial ischemic stroke

International Journal of Stroke ◽

10.1177/1747493016666089 ◽

2016 ◽

Vol 11 (9) ◽

pp. 1028-1035 ◽

Cited By ~ 10

Author(s):

Adam Kirton ◽

Elizabeth Williams ◽

Michael Dowling ◽

Sarah Mah ◽

Jacquie Hodge ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Ischemic Stroke ◽

Magnetic Resonance ◽

Diffusion Weighted Imaging ◽

Infarct Volume ◽

Resonance Imaging ◽

Arterial Ischemic Stroke ◽

Diffusion Weighted ◽

Motor Outcome

Background Diffusion-weighted imaging magnetic resonance imaging may detect changes in brain structures remote but connected to stroke consistent with neuropathological descriptions of diaschisis. Early diffusion-weighted imaging demonstrates restriction in corticospinal pathways after arterial ischemic stroke of all ages that correlates with motor outcome. Aim/hypothesis We hypothesized that cerebral diaschisis is measurable in childhood arterial ischemic stroke and explored associations with outcome. Methods This sub-study of the validation of the Pediatric NIH Stroke Scale study prospectively enrolled children with acute arterial ischemic stroke and both acute and early follow-up (5–14 days) diffusion-weighted imaging. Inclusion criteria were (1) unilateral middle cerebral artery arterial ischemic stroke, (2) acute and subacute diffusion-weighted imaging ( b = 1000), and (3) 12 month neurological follow-up (Pediatric Stroke Outcome Measure). A validated method using ImageJ software quantified diffusion-weighted imaging diaschisis in anatomically connected structures. Diaschisis measures were corrected for infarct volume, compared to age, imaging timing, and outcomes (Chi square/Fisher, Mann–Whitney test). Results Nineteen children (53% male, median 8.1 years) had magnetic resonance imaging at medians of 21 and 168 h post-stroke onset. Diaschisis was common and evolved over time, observed in one (5%) on acute but eight (42%) by follow-up diffusion-weighted imaging. Thalamic and callosal diaschisis were most common (5, 26%). Estimates of perilesional diaschisis varied (54 ± 18% of infarct volume). Children with diaschisis tended to be younger (7.02 ± 5.4 vs. 11.82 ± 4.3 years, p = 0.08). Total diaschisis score was associated with poor cognitive outcomes ( p = 0.03). Corticospinal tract diaschisis was associated with motor outcome ( p = 0.004). Method reliability was excellent. Conclusions Diffusion-weighted imaging diaschisis occurs in childhood arterial ischemic stroke. Mistaking diaschisis for new areas of infarction carries important clinical implications. Improved recognition and study are required to establish clinical relevance.

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The adjunctive value of diffusion weighted imaging in diagnosis and follow up of uterovaginal diffuse B-cell lymphoma: A case report and literature review.

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405617666210120094711 ◽

2021 ◽

Vol 17 ◽

Author(s):

Gehad A. Saleh ◽

Reham Alghandour ◽

Eman Y Rashad ◽

Ahmed M Tawfik ◽

Ali H. Elmokadem

Keyword(s):

Case Report ◽

B Cell ◽

Diffusion Weighted Imaging ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Diagnostic Methods ◽

Pelvic Mri ◽

Diffusion Weighted ◽

Large B Cell

Background: Lymphoma of the female gynecologic tract is extremely rare. Typically, lymphoma is managed non surgically unlike other non-lymphomatous malignant tumors raising the importance to differentiate between both entities. Case report: We describe the magnetic resonance imaging (MRI) features of a case of uterovaginal diffuse large B-cell lymphoma in a 50-year-old postmenopausal woman emphasizing Diffusion-Weighted Imaging (DWI) as a diagnostic and follow up tool. We reviewed the literature regarding the diagnostic methods for female genital lymphoma. Forty-five cases including our patient were reviewed with age range from 22 to 85 years. Vaginal bleeding was the most common presentation. The diagnosis was established by Papanicolaou smear, cervical biopsy (25/45), endometrial biopsy (6/45), vaginal biopsy (2/45), pelvic mass biopsy (2/45), iliac LN biopsy (1/45) and surgical diagnosis (8/45). Diffuse large B-cell lymphomas (DLBCL) constitute the vast majority of the cases (82%). The uterine cervix was involved at diagnosis in the majority of these cases (68%) while uterine body (42%) and vagina (28%) were less involved. Pelvic lymphadenopathy was found in 15 cases while extra genital lymphomatous infiltration in 13 cases. Sonographic findings were nonspecific while CT provided excellent data about extra-genital involvement. Thirteen cases underwent pelvic MRI that displayed superior detection of disease extension and parametric involvement. Diffusion restriction was reported only in one case without quantitative analysis of ADC map. Conclusion: MRI shows unique features that help to differentiate uterovaginal lymphoma from the much more common carcinomas and discriminate post-operative changes from tumor recurrence. It exhibits a marked restricted diffusion pattern with lower ADC values than carcinomas and post-operative changes.

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Diffusion-Weighted Imaging in Oncology: An Update

Cancers ◽

10.3390/cancers12061493 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1493 ◽

Cited By ~ 2

Author(s):

Carmelo Messina ◽

Rodolfo Bignone ◽

Alberto Bruno ◽

Antonio Bruno ◽

Federico Bruno ◽

...

Keyword(s):

Diffusion Weighted Imaging ◽

Water Molecules ◽

Non Invasive ◽

Diffusion Weighted ◽

Routine Magnetic Resonance Imaging ◽

Treatment Responses ◽

Magnetic Resonance Imaging Mri ◽

Almost All

To date, diffusion weighted imaging (DWI) is included in routine magnetic resonance imaging (MRI) protocols for several cancers. The real additive role of DWI lies in the “functional” information obtained by probing the free diffusivity of water molecules into intra and inter-cellular spaces that in tumors mainly depend on cellularity. Although DWI has not gained much space in some oncologic scenarios, this non-invasive tool is routinely used in clinical practice and still remains a hot research topic: it has been tested in almost all cancers to differentiate malignant from benign lesions, to distinguish different malignant histotypes or tumor grades, to predict and/or assess treatment responses, and to identify residual or recurrent tumors in follow-up examinations. In this review, we provide an up-to-date overview on the application of DWI in oncology.

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