scholarly journals Ferumoxytol-enhanced MR imaging for differentiating intrapancreatic splenules from other tumors

2020 ◽  
Author(s):  
M. R. Muehler ◽  
V. R. Rendell ◽  
L. L. Bergmann ◽  
E. R. Winslow ◽  
S. B. Reeder
Keyword(s):  
Superparamagnetic Iron Oxide ◽  
Pancreatic Neuroendocrine Tumor ◽  
Symptomatic Patient ◽  
Splenic Tissue ◽  
Pancreatic Lesion ◽  
Delayed Imaging ◽  
Post Contrast ◽  
Computed Tomographic ◽  
Institutional Experience ◽  
Slow Intravenous Infusion

Abstract Objectives Ferumoxytol is an ultra-small superparamagnetic iron oxide (USPIO) agent that is taken up by splenic tissue. This study describes our initial institutional experience of ferumoxytol-enhanced MRI (feMRI) for differentiating intrapancreatic splenules (IPS) from other pancreatic lesions. Methods In this retrospective study, patients with computed tomographic imaging that identified small enhancing lesions in the tail of the pancreas subsequently underwent feMRI for further characterization. The feMRI protocol included T2-weighted (T2w) imaging with and without fat suppression (FS), R2* mapping, diffusion-weighted imaging (DWI), and T1-weighted (T1w) imaging with FS, prior to contrast injection. Immediately after slow intravenous infusion with 3 mg/kg body weight ferumoxytol, T1w was repeated. Delayed imaging with all sequences were obtained 24–72 h after ferumoxytol administration. Results Seven patients underwent feMRI. In two patients, the pancreatic lesions were presumed as pancreatic neuroendocrine tumor (PNET) from feMRI and in the remaining 5 IPS. One of the two patients with PNET was symptomatic for NET. In another symptomatic patient with pathologically proven duodenal NET and suspected PNET, the pancreatic lesion was proven to be an IPS on feMRI. IPS demonstrated strong negative enhancement in feMRI on T2w and increased R2* values consistent with splenic tissue, while the presumed PNETs did not enhance. T2w FS was helpful on the pre-contrast images to identify IPS, while R2* did on post-contrast images. Neither DWI nor T1w contributed to differentiating PNETs from IPS. Conclusions This study demonstrates the potential utility of feMRI as a helpful adjunct diagnostic tool for differentiating IPS from other pancreatic lesions. Further studies in larger patient cohorts are needed.

scholarly journals Multi-factorial considerations for intra-thoracic lymph node evaluations of healthy cats on computed tomographic images

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Ninlawan Thammasiri ◽  
Chutimon Thanaboonnipat ◽  
Nan Choisunirachon ◽  
Damri Darawiroj
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Ct Images ◽  
Slice Thickness ◽  
Maximum Width ◽  
Post Contrast ◽  
Computed Tomographic ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

Abstract Background It is difficult to examine mild to moderate feline intra-thoracic lymphadenopathy via and thoracic radiography. Despite previous information from computed tomographic (CT) images of intra-thoracic lymph nodes, some factors from animals and CT setting were less elucidated. Therefore, this study aimed to investigate the effect of internal factors from animals and external factors from the CT procedure on the feasibility to detect the intra-thoracic lymph nodes. Twenty-four, client-owned, clinically healthy cats were categorized into three groups according to age. They underwent pre- and post-contrast enhanced CT for whole thorax followed by inter-group evaluation and comparison of sternal, cranial mediastinal, and tracheobronchial lymph nodes. Results Post contrast-enhanced CT appearances revealed that intra-thoracic lymph nodes of kittens were invisible, whereas the sternal, cranial mediastinal, and tracheobronchial nodes of cats aged over 7 months old were detected (6/24, 9/24 and 7/24, respectively). Maximum width of these lymph nodes were 3.93 ± 0.74 mm, 4.02 ± 0.65 mm, and 3.51 ± 0.62 mm, respectively. By age, lymph node sizes of these cats were not significantly different. Transverse lymph node width of males was larger than that of females (P = 0.0425). Besides, the detection score of lymph nodes was affected by slice thickness (P < 0.01) and lymph node width (P = 0.0049). Furthermore, an irregular, soft tissue structure, possibly the thymus, was detected in all juvenile cats and three mature cats. Conclusions Despite additional information on intra-thoracic lymph nodes in CT images, which can be used to investigate lymphatic-related abnormalities, age, sex, and slice thickness of CT images must be also considered.

scholarly journals A Case Report: Insulinoma in a Military Pilot Detected by 68Ga-Dotatate PET/CT

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1887-e1890
Author(s):  
Lisa D Larose ◽  
Penny J Vroman ◽  
Sierra R Musick ◽  
Alexis A Beauvais
Keyword(s):  
Neuroendocrine Tumor ◽  
Air Force ◽  
Imaging Modality ◽  
Pancreatic Neuroendocrine Tumor ◽  
Altered Mental Status ◽  
Laparoscopic Distal Pancreatectomy ◽  
Nuclear Medicine Imaging ◽  
Pancreatic Lesion ◽  
Pet Ct ◽  
Initial Imaging

Abstract A 37-year-old active duty male Air Force instructor pilot, with no prior medical history, was found unresponsive at his home after awakening with symptoms of altered mental status when the Emergency Medical Service (EMS) was called. The patient was found to be hypoglycemic with a glucose of 37 mg/dL. The patient recovered after administration of a dextrose bolus. Further investigation revealed that over the last several years, the patient exhibited symptoms of lightheadedness and tremors if fasted greater than 3 hours. Further clinical workup strongly suggested the presence of a neuroendocrine tumor. Initial imaging studies to include a multiphasic dedicated pancreatic computed tomography (CT) scan did not demonstrate a pancreatic lesion. However, the utilization of an innovative new nuclear medicine imaging modality, a 68Ga-Dotatate PET/CT, clearly demonstrated a 19 × 16 mm lesion of the distal pancreatic tail, which guided surgical resection. He underwent a robotic-assisted laparoscopic distal pancreatectomy, pathologically characterized as an insulinoma. The patient’s symptoms immediately resolved with no recurrence over the next 6 months. The pilot was granted a waiver, returning him to his flying duties. The 68Ga-Dotatate PET/CT enabled the identification of an otherwise occult pancreatic neuroendocrine tumor ultimately leading to this patient’s definitive cure and the salvage of this military asset’s aviation career.

scholarly journals Diagnostic Accuracy of Delayed Phase Post Contrast Computed Tomographic Images in the Diagnosis of Focal Liver Lesions in Dogs: 69 Cases

2021 ◽  
Vol 8 ◽  
Author(s):  
Silvia Burti ◽  
Alessandro Zotti ◽  
Federico Bonsembiante ◽  
Barbara Contiero ◽  
Tommaso Banzato
Keyword(s):  
Machine Learning ◽  
Decision Tree ◽  
Normal Liver ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Quantitative Ct ◽  
Post Contrast ◽  
Surface Appearance ◽  
Computed Tomographic ◽  
Ct Features

To describe the computed tomographic (CT) features of focal liver lesions (FLLs) in dogs, that could enable predicting lesion histotype. Dogs diagnosed with FLLs through both CT and cytopathology and/or histopathology were retrospectively collected. Ten qualitative and 6 quantitative CT features have been described for each case. Lastly, a machine learning-based decision tree was developed to predict the lesion histotype. Four categories of FLLs - hepatocellular carcinoma (HCC, n = 13), nodular hyperplasia (NH, n = 19), other benign lesions (OBL, n = 18), and other malignant lesions (OML, n = 19) - were evaluated in 69 dogs. Five of the observed qualitative CT features resulted to be statistically significant in the distinction between the 4 categories: surface, appearance, lymph-node appearance, capsule formation, and homogeneity of contrast medium distribution. Three of the observed quantitative CT features were significantly different between the 4 categories: the Hounsfield Units (HU) of the radiologically normal liver parenchyma during the pre-contrast scan, the maximum dimension, and the ellipsoid volume of the lesion. Using the machine learning-based decision tree, it was possible to correctly classify NHs, OBLs, HCCs, and OMLs with an accuracy of 0.74, 0.88, 0.87, and 0.75, respectively. The developed decision tree could be an easy-to-use tool to predict the histotype of different FLLs in dogs. Cytology and histology are necessary to obtain the final diagnosis of the lesions.

scholarly journals Feline injection site sarcoma: computed-tomographic density and assessment of tumor dimensions by different methods

2017 ◽  
Vol 37 (10) ◽  
pp. 1113-1118
Author(s):  
Karen Maciel Zardo ◽  
Lucas Petri Damiani ◽  
Julia Maria Matera ◽  
Ana Carolina B.C. Fonseca-Pinto
Keyword(s):  
Physical Examination ◽  
Injection Site ◽  
Malignant Neoplasm ◽  
Hounsfield Unit ◽  
Ct Images ◽  
Post Contrast ◽  
Computed Tomographic ◽  
Definition Of ◽  
Ct Density ◽  
Contrast Ct

ABSTRACT: Feline injection site sarcoma is a malignant neoplasm with digitiform projections into muscular planes that are ill recognized during physical examination and may compromise tumor margin demarcation. This study compared tumoral size of 32 cats measured by different methods, and evaluated the CT density of 10 tumoral tissues (Hounsfield unit) based on histograms. Tumor axes were measured by physical examination and CT images. Larger craniocaudal axis measurements were obtained following multiplanar reconstruction of pre- and post-contrast CT images (p=0.049 and p=0.041 respectively); dorsoventral axis measurements taken from post-contrast CT images were also larger (p=0.010). Tumor volume estimates increased following contrast-enhancement. Histograms tended to produce two peaks: one in the fat and another in the soft tissue attenuation range. Multiplanar reconstructed post-contrast CT images provided clearer definition of tumor margins and more judicious determination of tumor size. A tendency of common FISS attenuation profile could be described.

scholarly journals Computed tomographic features of the feline brain change with advancing age?

2015 ◽  
Vol 35 (suppl 1) ◽  
pp. 33-38
Author(s):  
Viviam R. Babicsak ◽  
Guilherme S. Cardoso ◽  
Miriam H. Tsunemi ◽  
Luiz C. Vulcano
Keyword(s):  
Third Ventricle ◽  
Imaging Data ◽  
Falx Cerebri ◽  
Post Contrast ◽  
Computed Tomographic ◽  
Age Related ◽  
Left Lateral Ventricle ◽  
Mean Width ◽  
Contrast Ct ◽  
Age Related Changes

Abstract: A better understanding of normal or expected encephalic changes with increasing age in cats is needed as a growing number of these animals is attended in veterinary clinics, and imaging data referring to normal age-associated changes are extremely scarce in the literature. The objective of this study was to identify age-related changes in feline brain using CT imaging. Fifteen non-brachycephalic healthy cats with age between 1 to 6 years (adult group) and others over 12 years (geriatric group) were submitted to CT scan of the brain. Statistically significant differences were found between the groups for the ability to identify the left lateral ventricle and for falx cerebri calcification, both identified in a greater number of cats of the geriatric group. A significantly higher mean width of the third ventricle was also detected in geriatric animals. There were no statistically significant differences between lateral ventricular dimensions and encephalic parenchymal attenuation on pre and post-contrast CT phases. The results of the present study show an increase in the incidence of falx cerebri calcification and a third ventricular dilatation with advancing age in cats. Future researches using MRI scanners and a greater quantity of cats are needed in order to identify supplementary age-related changes.

scholarly journals Traumatic Injury Causing Intraperitoneal Hemorrhage of an Occult Pheochromocytoma

2012 ◽  
Vol 2012 ◽  
pp. 1-6
Author(s):  
Arpit Amin ◽  
Saptarshi Biswas ◽  
Francis Baccay
Keyword(s):  
Traumatic Injury ◽  
Hypovolemic Shock ◽  
Arterial Embolization ◽  
Symptomatic Patient ◽  
Critically Ill Patient ◽  
Rare Presentation ◽  
Computed Tomographic ◽  
Active Extravasation ◽  
The Right ◽  
Traumatic Hemorrhage

Pheochromocytoma is a rare catecholamine-secreting tumor derived from chromaffin cells. The diagnosis is usually suggested by classic history in a symptomatic patient, presence of a strong family history in a patient, or discovery of an incidental mass on imaging in an asymptomatic patient. Traumatic hemorrhage into an occult pheochromocytoma presenting as hypovolemic shock is a rare presentation of pheochromocytoma. We report a case of a 48-year-old female, who presented in hypovolemic shock due to unilateral adrenal hemorrhage secondary to a fall from horse. Computed tomographic imaging revealed that the source of the hypovolemic shock was hemorrhagic right adrenal mass with active extravasation. The patient underwent emergent selective arterial embolization of right superior adrenal artery and a small adrenal branch from the right renal artery to control the hemorrhage. The patient subsequently progressed to sepsis and MODS, needing multiple surgical procedures and a protracted recovery in the ICU. In the ICU, the patient suffered from rapid cyclic fluctuation of her systolic blood pressure and was subsequently diagnosed with pheochromocytoma secondary to traumatic hemorrhage. We discuss this rare case along with the presentation and diagnostic workup of this critically ill patient with a previously undiagnosed pheochromocytoma.

DETERMINATION OF THE ENHANCEMENT EFFECT AND DIAMETERS OF THE MAJOR ARTERIES OF AFRICAN GREY PARROTS USING A DUAL-HEAD POWER INJECTOR FOR COMPUTED TOMOGRAPHIC ANGIOGRAPHY

2015 ◽  
Vol 41 (03) ◽  
pp. 165-175 ◽  
Author(s):  
Yen-Lin Lee ◽  
Pin-Huan Yu ◽  
Chia-Li Chen ◽  
Ying-Ling Wu ◽  
Chau-Hwa Chi
Keyword(s):  
Contrast Medium ◽  
Computed Tomographic Angiography ◽  
The Body ◽  
Enhancement Effect ◽  
Reference Ranges ◽  
Post Contrast ◽  
Computed Tomographic ◽  
Diagnostic Potential ◽  
Power Injector ◽  
Tomographic Angiography

The aim of the present study was to establish a computed tomographic angiography protocol using a dual-head power injector as well as measure the attenuation values and diameters of the major arteries in African Grey parrots (Psittacus erithacus). A 16-slice computed tomography (CT) scanner was used to measure the region of interest (ROI) in six major arteries. Before scanning, each bird underwent physical, blood, and cardiological examinations and were considered healthy. Each bird was sedated under general anesthesia during the CT-angiography (CT-A) procedure. A dual-head power injector with a saline chaser technique was used to administer the contrast medium and saline flush. We used a real-time bolus-tracking method and triggered the scan manually once the peak enhancement of ascending aorta was reached. All measurements were made by two double-blinded clinicians. The reference ranges before and after contrast medium administration via the body, pulmonary, and bone windows were set up accordingly. Inter-observer consistency in measurements was high in post-contrast values via the body window. Hence, the present study concluded that it is feasible to use saline chaser with dual-head power injector upon performing CT-A in parrots and analyze the image in a body window. Also, an anesthetic protocol during CT-A was also proved to be practical. However, further studies are needed to improve the diagnostic potential and utility of CT-A in parrots.

scholarly journals Falling under the umbrella cells: A single institutional experience and literature review of urothelial carcinoma presenting as a primary pancreatic mass on endoscopic ultrasound-guided fine-needle aspiration

CytoJournal ◽  
2017 ◽  
Vol 14 ◽  
pp. 6
Author(s):  
Michael Chambers ◽  
Konrad Krall ◽  
Shantel Hébert-Magee
Keyword(s):  
Urothelial Carcinoma ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Ultrasound Guided ◽  
Pancreatic Lesion ◽  
Fine Needle ◽  
Institutional Experience ◽  
Metastatic Urothelial Carcinoma ◽  
Site Evaluation

Metastases to the pancreas are much less common than primary pancreatic lesions, and there are few reports in the literature of metastatic urothelial carcinoma (UC) found in the pancreas. We report two cases of metastatic UC mimicking a primary pancreatic lesion. Two female patients, aged 48 and 83 years, presented with isolated pancreatic lesions causing obstructive jaundice suspicious for pancreatic adenocarcinoma and underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) with rapid on-site evaluation (ROSE). On cytopathology, the lesions were found to be UC, confirmed with immunohistochemical (IHC) staining. UC rarely metastasizes to the pancreas, and diagnosis through EUS-FNA can be challenging. However, the utilization of ROSE, dedicated cell block passes, and IHC have proved to be effective in obtaining this unusual pancreatic diagnosis by EUS-FNA.

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