An abbreviated MRI protocol for surveillance of cystic pancreatic lesions

The results of 205 puncture biopsies of solid and cystic pancreatic lesions performed in 202 patients at the Republican Oncological Dispensary of the Republic of Karelia for a 7-year period (2009-2015) are presented. Informative material for morphological investigation was obtained in 95.5% of cases. A comparison of results of cytological examination of the material from 56 patients with pancreatic lesions with histological data was carried out. The efficiency of the cytological method was 90.6%, sensitivity - 87.8%, specificity - 100%. To determine histological form of tumor in cytological examination of the material of the pancreas was successful in 82.1% of cases.

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Pearls and Pitfalls of Contrast-Enhanced Mammography

Journal of Breast Imaging ◽

10.1093/jbi/wby013 ◽

2019 ◽

Vol 1 (1) ◽

pp. 64-72 ◽

Cited By ~ 4

Author(s):

Jordana Phillips ◽

Valerie J Fein-Zachary ◽

Priscilla J Slanetz

Keyword(s):

Imaging Modality ◽

Breast Mri ◽

Successful Implementation ◽

Newly Diagnosed ◽

Disease Extent ◽

Diagnostic Problem Solving ◽

Contrast Enhanced ◽

Comparable Performance ◽

Mri Protocol ◽

Monitoring Response

Abstract Contrast-enhanced mammography (CEM) is a promising new imaging modality that uses a dual-energy acquisition to provide both morphologic and vascular assessment of breast lesions. Although no official BI-RADS lexicon exists, interpretation entails using the mammographic BI-RADS lexicon in combination with that for breast MRI. CEM has comparable performance to breast MRI, with sensitivity of 93–100% and specificity of 80–94%. Currently FDA approved for diagnostic imaging, this technology can be helpful in determining disease extent in patients with newly diagnosed breast malignancy, monitoring response to neoadjuvant therapy, identifying mammographically occult malignancies, and diagnostic problem-solving. Studies are ongoing about its role in screening, especially in women with dense breasts or at elevated risk. There are some challenges to successful implementation into practice, but overall, patients tolerate the study well, and exam times are less than the full breast MRI protocol.

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Non-contrast MRI can accurately characterize adnexal masses: a retrospective study

European Radiology ◽

10.1007/s00330-021-07737-9 ◽

2021 ◽

Author(s):

Hilal Sahin ◽

Camilla Panico ◽

Stephan Ursprung ◽

Vittorio Simeon ◽

Paolo Chiodini ◽

...

Keyword(s):

Contrast Medium ◽

High Accuracy ◽

Receiver Operating Curve ◽

Intravenous Contrast ◽

Random Subset ◽

Adnexal Masses ◽

Intravenous Contrast Medium ◽

Mri Protocol ◽

Malignant Lesions ◽

Mri Score

Abstract Objective To determine the accuracy of interpretation of a non-contrast MRI protocol in characterizing adnexal masses. Methods and materials Two hundred ninety-one patients (350 adnexal masses) who underwent gynecological MRI at our institution between the 1st of January 2008 and the 31st of December 2018 were reviewed. A random subset (102 patients with 121 masses) was chosen to evaluate the reproducibility and repeatability of readers’ assessments. Readers evaluated non-contrast MRI scans retrospectively, assigned a 5-point score for the risk of malignancy and gave a specific diagnosis. The reference standard for the diagnosis was histopathology or at least one-year imaging follow-up. Diagnostic accuracy of the non-contrast MRI score was calculated. Inter- and intra-reader agreement was analyzed with Cohen’s kappa statistics. Results There were 53/350 (15.1%) malignant lesions in the whole cohort and 20/121 (16.5%) malignant lesions in the random subset. Good agreement between readers was found for the non-contrast MRI score (к = 0.73, 95% confidence interval [CI] 0.58–0.86) whilst the intra-reader agreement was excellent (к = 0.81, 95% CI 0.70–0.88). The non-contrast MRI score value of ≥ 4 was associated with malignancy with a sensitivity of 84.9%, a specificity of 95.9%, an accuracy of 94.2% and a positive likelihood ratio of 21 (area under the receiver operating curve 0.93, 95% CI 0.90–0.96). Conclusion Adnexal mass characterization on MRI without the administration of contrast medium has a high accuracy and excellent inter- and intra-reader agreement. Our results suggest that non-contrast studies may offer a reasonable diagnostic alternative when the administration of intravenous contrast medium is not possible. Key Points • A non-contrast pelvic MRI protocol may allow the characterization of adnexal masses with high accuracy. • The non-contrast MRI score may be used in clinical practice for differentiating benign from malignant adnexal lesions when the lack of intravenous contrast medium precludes analysis with the O–RADS MRI score.

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Coronal STIR sequence, a simple adjustment to routine MRI protocol for extra-spinal sciatica and sciatica-like symptoms

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-019-0096-6 ◽

2019 ◽

Vol 50 (1) ◽

Author(s):

Rania Zeitoun ◽

Mohammed Saleh Ali Mohieddin

Keyword(s):

Young Adults ◽

Soft Tissue ◽

Mr Imaging ◽

Age Groups ◽

Field Of View ◽

Mri Protocol ◽

Stir Sequence ◽

Tissue Abnormalities ◽

Additional Value ◽

Bone Abnormalities

Abstract Background The value of adding coronal STIR images to MR imaging of sciatica aiming to detect extra-spinal abnormalities. Results Additional coronal STIR images detected extra-spinal abnormalities in 20% of the patients, thereby downgraded the normal studies from 21 to 13%. The extra-spinal abnormalities included bone abnormalities (36.4%), soft tissue abnormalities (4.5%), neurological abnormalities (2.3%), gynecological abnormalities (50%), and miscellaneous (6.8%). In 6.9% of patients, the extra-spinal abnormalities explained the patients’ pain and influenced their management. Extra-spinal causes of pain significantly correlated to positive trauma and neoplasm history, normal routine protocol images, and absent nerve root impingement. Extra-spinal abnormalities were more prevalent in age groups (20–39 years). Conclusion Coronal STIR images (field of view: mid abdomen to the lesser trochanters) identify extra-spinal abnormalities that maybe overlooked on routine MRI protocol. It is of additional value in young adults, trauma, neoplasm, and negative routine images.

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Diagnostic Value of Whole-Body MRI Short Protocols in Bone Lesion Detection in Multiple Myeloma Patients

Diagnostics ◽

10.3390/diagnostics11061053 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1053

Author(s):

Davide Ippolito ◽

Teresa Giandola ◽

Cesare Maino ◽

Davide Gandola ◽

Maria Ragusi ◽

...

Keyword(s):

Multiple Myeloma ◽

Bone Marrow Involvement ◽

Bone Lesion ◽

Diagnostic Value ◽

Lesion Detection ◽

Lower Limbs ◽

Whole Body ◽

Bone Lesions ◽

Whole Body Mri ◽

Mri Protocol

The aim of the study is to evaluate the effectiveness of short whole-body magnetic resonance imaging (WBMRI) protocols for the overall assessment of bone marrow involvement in patients with multiple myeloma (MM), in comparison with standard whole-body MRI protocol. Patients with biopsy-proven MM, who underwent a WBMRI with full-body coverage (from vertex to feet) were retrospectively enrolled. WBMRI images were independently evaluated by two expert radiologists, in terms of infiltration patterns (normal, focal, diffuse, and combined), according to location (the whole skeleton was divided into six anatomic districts: skull, spine, sternum and ribs, upper limbs, pelvis and proximal two-thirds of the femur, remaining parts of lower limbs) and lytic lesions number (<5, 5–20, and >20). The majority of patients showed focal and combined infiltration patterns with bone lesions predominantly distributed in the spine and pelvis. As skull and lower limbs are less frequently involved by focal bone lesions, excluding them from the standard MRI protocol allows to obtain a shorter protocol, maintaining a good diagnostic value.

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Application of artificial intelligence in pancreaticobiliary diseases

Therapeutic Advances in Gastrointestinal Endoscopy ◽

10.1177/2631774521993059 ◽

2021 ◽

Vol 14 ◽

pp. 263177452199305

Author(s):

Hemant Goyal ◽

Rupinder Mann ◽

Zainab Gandhi ◽

Abhilash Perisetti ◽

Zhongheng Zhang ◽

...

Keyword(s):

Artificial Intelligence ◽

Response To Treatment ◽

Endoscopic Retrograde ◽

Artificial Intelligence Techniques ◽

Computer Aided ◽

Rapid Pace ◽

Cystic Pancreatic Lesions ◽

Aided Diagnosis

The role of artificial intelligence and its applications has been increasing at a rapid pace in the field of gastroenterology. The application of artificial intelligence in gastroenterology ranges from colon cancer screening and characterization of dysplastic and neoplastic polyps to the endoscopic ultrasonographic evaluation of pancreatic diseases. Artificial intelligence has been found to be useful in the evaluation and enhancement of the quality measure for endoscopic retrograde cholangiopancreatography. Similarly, artificial intelligence techniques like artificial neural networks and faster region-based convolution network are showing promising results in early and accurate diagnosis of pancreatic cancer and its differentiation from chronic pancreatitis. Other artificial intelligence techniques like radiomics-based computer-aided diagnosis systems could help to differentiate between various types of cystic pancreatic lesions. Artificial intelligence and computer-aided systems also showing promising results in the diagnosis of cholangiocarcinoma and the prediction of choledocholithiasis. In this review, we discuss the role of artificial intelligence in establishing diagnosis, prognosis, predicting response to treatment, and guiding therapeutics in the pancreaticobiliary system.

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