Magnetic resonance cisternography imaging findings related to the leakage of Gadolinium into the subarachnoid space

Abstract Purpose To identify magnetic resonance cisternography (MRC) imaging findings related to Gadolinium-based contrast agent (GBCA) leakage into the subarachnoid space. Materials and methods The number of voxels of GBCA leakage (V-leak) on 3D-real inversion recovery images was measured in 56 patients scanned 4 h post-intravenous GBCA injection. Bridging veins (BVs) were identified on MRC. The numbers of BVs with surrounding cystic structures (BV-cyst), with arachnoid granulations protruding into the superior sagittal sinus (BV-AG-SSS) and the skull (BV-AG-skull), and including any of these factors (BV-incl) were recorded. Correlations between these variables and V-leak were examined based on the Spearman’s rank correlation coefficient. Receiver-operating characteristic (ROC) curves were generated to investigate the predictive performance of GBCA leakage. Results V-leak and the number of BV-incl were strongly correlated (r = 0.609, p < 0.0001). The numbers of BV-cyst and BV-AG-skull had weaker correlations with V-leak (r = 0.364, p = 0.006; r = 0.311, p = 0.020, respectively). The number of BV-AG-SSS was not correlated with V-leak. The ROC curve for contrast leakage exceeding 1000 voxels and the number of BV-incl had moderate accuracy, with an area under the curve of 0.871. Conclusion The number of BV-incl may be a predictor of GBCA leakage and a biomarker for waste drainage function without using GBCA.

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Evaluation of the clot burden score (cbs) for acute ischemic stroke (ais) in intent-to-treat patients.

Journal Of Cardiovascular, Neurovascular & Stroke ◽

10.32896/cvns.v1n1.11-15 ◽

2019 ◽

Vol 1 (1) ◽

pp. 11-15 ◽

Cited By ~ 1

Author(s):

Sarah Yaziz ◽

Ahmad Sobri Muda ◽

Wan Asyraf Wan Zaidi ◽

Nik Azuan Nik Ismail

Keyword(s):

Ischemic Stroke ◽

Clinical Outcome ◽

Acute Ischemic Stroke ◽

Predictive Value ◽

Area Under The Curve ◽

Rank Correlation ◽

Treatment Decision ◽

Roc Curves ◽

Significant Negative Correlation ◽

Clot Burden

Background : The clot burden score (CBS) is a scoring system used in acute ischemic stroke (AIS) to predict patient outcome and guide treatment decision. However, CBS is not routinely practiced in many institutions. This study aimed to investigate the feasibility of CBS as a relevant predictor of good clinical outcome in AIS cases. Methods: A retrospective data collection and review of AIS patients in a teaching hospital was done from June 2010 until June 2015. Patients were selected following the inclusion and exclusion criteria. These patients were followed up after 90 days of discharge. The Modified Rankin scale (mRS) was used to assess their outcome (functional status). Linear regression Spearman Rank correlation was performed between the CBS and mRS. The quality performance of the correlations was evaluated using Receiver operating characteristic (ROC) curves. Results: A total of 89 patients with AIS were analysed, 67.4% (n=60) male and 32.6% (n=29) female. Twenty-nine (29) patients (33.7%) had a CBS ?6, 6 patients (6.7%) had CBS <6, while 53 patients (59.6%) were deemed clot free. Ninety (90) days post insult, clinical assessment showed that 57 (67.6%) patients were functionally independent, 27 (30.3%) patients functionally dependent, and 5 (5.6%) patients were deceased. Data analysis reported a significant negative correlation (r= -0.611, p<0.001). ROC curves analysis showed an area under the curve of 0.81 at the cut-off point of 6.5. This showed that a CBS of more than 6 predicted a good mRS clinical outcome in AIS patients; with sensitivity of 98.2%, specificity of 53.1%, positive predictive value (PPV) of 76%, and negative predictive value (NPV) of 21%. Conclusion: CBS is a useful additional variable for the management of AIS cases, and should be incorporated into the routine radiological reporting for acute ischemic stroke (AIS) cases.

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A predictive model to estimate survival of hospitalized COVID-19 patients from admission data

10.1101/2020.04.22.20075416 ◽

2020 ◽

Cited By ~ 6

Author(s):

Todd J. Levy ◽

Safiya Richardson ◽

Kevin Coppa ◽

Douglas P. Barnaby ◽

Thomas McGinn ◽

...

Keyword(s):

Survival Probability ◽

Predictive Accuracy ◽

Area Under The Curve ◽

Predictive Performance ◽

Roc Curves ◽

Severity Index ◽

Primary Objective ◽

Lasso Regression ◽

Distribution Width ◽

Serum Blood Urea Nitrogen

AbstractObjectiveOur primary objective was to use initial data available to clinicians to characterize and predict survival for hospitalized coronavirus disease 2019 (COVID-19) patients. While clinical characteristics and mortality risk factors of COVID-19 patients have been reported, a practical survival calculator based on data from a diverse group of U.S. patients has not yet been introduced. Such a tool would provide timely and valuable guidance in decision-making during this global pandemic.DesignWe extracted demographic, laboratory, clinical, and treatment data from electronic health records and used it to build and test the predictive accuracy of a survival probability calculator referred to as “the Northwell COVID-19 Survival (‘NOCOS’) calculator.”Setting13 acute care facilities at Northwell Health served as the setting for this study.Participants5,233 hospitalized COVID-19–positive patients served as the participants for this study.Main outcome measuresThe NOCOS calculator was constructed using multivariate regression with L1 regularization (LASSO) to predict survival during hospitalization. Model predictive performance was measured using Receiver Operating Characteristic (ROC) curves and the Area Under the Curve (AUC) of the calculators.ResultsPatient age, serum blood urea nitrogen, Emergency Severity Index, red cell distribution width, absolute neutrophil count, serum bicarbonate, and glucose were identified as the optimal predictors of survival by multivariate LASSO regression. The predictive performance of the NOCOS calculator had an AUC of 0.832, reaching 0.91 when updated for each patient daily, with stability assessed and maintained for 14 consecutive days. This outperformed other established models, including the Sequential Organ Failure Assessment (SOFA) score (0.732).ConclusionsWe present a practical estimate of survival probability that outperforms other general risk models. The seven early predictors of in-hospital survival can help clinicians identify patients with increased probabilities of survival and provide critical decision support as COVID-19 spreads across the U.S.Trial registrationN/A

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Direct venous spinal reabsorption of cerebrospinal fluid: a new concept with serial magnetic resonance cisternography in rabbits

Journal of Neurosurgery Spine ◽

10.3171/2011.12.spine11108 ◽

2012 ◽

Vol 16 (4) ◽

pp. 394-401 ◽

Cited By ~ 9

Author(s):

Huseyin Biceroglu ◽

Sait Albayram ◽

Sabri Ogullar ◽

Zehra Isik Hasiloglu ◽

Hakan Selcuk ◽

...

Keyword(s):

Magnetic Resonance ◽

Mr Imaging ◽

Contrast Agent ◽

Subarachnoid Space ◽

White Male ◽

Imaging Study ◽

Contrast Injection ◽

Mr Cisternography ◽

Sagittal Sinus ◽

Imaging Results

Object For nearly 100 years it has been believed that the main reabsorption of CSF occurs in arachnoid projections into the superior sagittal sinus, but a significant number of experiments and cases conflict with this hypothesis. According to recently published studies, CSF is permanently produced and absorbed in the whole CSF system. Clusters of arachnoidal villi, which are speculated to have a role in the reabsorption of CSF, have recently been revealed in the dorsal root of the spinal nerves. Huge absorptive surface areas of microvessels have been suggested to serve a putative role in reabsorption. The authors' aim was to observe direct venous connections between the subarachnoid space and the perispinal veins. Methods Eleven adult (6 months old) New Zealand white male rabbits weighing approximately 3.0 kg each were used in this experiment. After obtaining precontrast MR cisternography images, subarachnoid access was gained percutaneously via a cisternal approach by using a 20-gauge intravenous indwelling cannula. One rabbit died as a result of brainstem trauma during percutaneous cannulation before contrast administration, but contrast agent was still injected to see the possible MR imaging results of spinal CSF reabsorption after death. Magnetic resonance imaging was performed at 15, 60, 120, and 180 minutes after the administration of contrast agent. After intramuscular injections of anesthetic, 2 rabbits died 120 and 150 minutes after contrast injection, but the MR imaging study at 180 minutes after contrast injection was still performed. Results Direct connections between the subarachnoid space and the perispinal veins were observed in all rabbits during serial MR cisternography. The enhancement power was not affected by the amount of injected contrast agent or by cervical or lumbar penetration but was increased at higher contrast concentrations or upon seizure (physical activity). Conclusions Extracranial reabsorption of CSF has been finally proved with direct radiological confirmation of spinal venous reabsorption of CSF using serial MR cisternography. The authors believe that this study can help to develop a more accurate model of CSF dynamics, which will allow understanding of many CSF-related diseases, as well as the development of new strategies for treatment.

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Comparison of predictive performance for toxicity by accumulative dose of DVH parameter addition and DIR addition for cervical cancer patients

Journal of Radiation Research ◽

10.1093/jrr/rraa099 ◽

2020 ◽

Vol 62 (1) ◽

pp. 155-162

Author(s):

Yuya Miyasaka ◽

Noriyuki Kadoya ◽

Rei Umezawa ◽

Yoshiki Takayama ◽

Kengo Ito ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Patients ◽

Operating Characteristic ◽

External Beam Radiotherapy ◽

Area Under The Curve ◽

Predictive Performance ◽

Roc Curves ◽

Dose Volume ◽

Gi Toxicity ◽

The Difference

Abstract We compared predictive performance between dose volume histogram (DVH) parameter addition and deformable image registration (DIR) addition for gastrointestinal (GI) toxicity in cervical cancer patients. A total of 59 patients receiving brachytherapy and external beam radiotherapy were analyzed retrospectively. The accumulative dose was calculated by three methods: conventional DVH parameter addition, full DIR addition and partial DIR addition. ${D}_{2{cm}^3}$, ${D}_{1{cm}^3}$ and ${D}_{0.1{cm}^3}$ (minimum doses to the most exposed 2 cm3, 1cm3 and 0.1 cm3 of tissue, respectively) of the rectum and sigmoid were calculated by each method. V50, V60 and V70 Gy (volume irradiated over 50, 60 and 70 Gy, respectively) were calculated in full DIR addition. The DVH parameters were compared between toxicity (≥grade1) and non-toxicity groups. The area under the curve (AUC) of the receiver operating characteristic (ROC) curves were compared to evaluate the predictive performance of each method. The differences between toxicity and non-toxicity groups in ${D}_{2{cm}^3}$ were 0.2, 5.7 and 3.1 Gy for the DVH parameter addition, full DIR addition and partial DIR addition, respectively. The AUCs of ${D}_{2{cm}^3}$ were 0.51, 0.67 and 0.57 for DVH parameter addition, full DIR addition and partial DIR addition, respectively. In full DIR addition, the difference in dose between toxicity and non-toxicity was the largest and AUC was the highest. AUCs of V50, V60 and V70 Gy were 0.51, 0.63 and 0.62, respectively, and V60 and V70 were high values close to the value of ${D}_{2{cm}^3}$ of the full DIR addition. Our results suggested that the full DIR addition may have the potential to predict toxicity more accurately than the conventional DVH parameter addition, and that it could be more effective to accumulate to all pelvic irradiation by DIR.

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Total Amylase Value in Drains After Gastrectomy for Predicting Postoperative Pancreatic Fistula

International Surgery ◽

10.9738/intsurg-d-17-00127.1 ◽

2020 ◽

Author(s):

Toshitaka Sugawara ◽

Hisashi Shinohara ◽

Shusuke Haruta ◽

Junichi Shindo ◽

Masaki Ueno ◽

...

Keyword(s):

Pancreatic Fistula ◽

Concentration Ratio ◽

Univariate Analysis ◽

Area Under The Curve ◽

Predictive Performance ◽

Roc Curves ◽

Postoperative Pancreatic Fistula ◽

Amylase Level ◽

Anastomotic Site ◽

Drainage Fluid

Objective: Postoperative pancreatic fistula (POPF) is defined using the ratio of the bilirubin concentration in abdominal drainage fluid to the upper normal range of serum amylase level. However, we hypothesized that the total amylase value in discharge (AVD) on POD 3 may be more sensitive for predicting grade II or higher severe POPF sPOPF, and compared the predictive power of the conventional definition of POPF and AVD for sPOPF. Methods: One hundred and fifty-one patients who underwent gastrectomy between October 2011 and February 2013 were analyzed. A drainage tube was placed in all the cases through the stump of the right gastroepiploic vein and the front of the pancreas to the back of the anastomotic site. The drainage volume and amylase concentration in the discharge were examined on POD 1, 3, and 5. AVD was calculated by multiplying the volume by the amylase concentration. Results: Eight patients (5.3%) developed sPOPF. In univariate analysis, both AVD and the amylase concentration ratio was significantly correlated with sPOPF (P = 0.002 and 0.007, respectively). AVD on POD 3 showed the best predictive performance compared with the amylase concentration ratio on POD 3 (area under the curve 0.876 vs. 0.844). Based on the cutoff values calculated from the ROC curves, AVD was more specific than amylase concentration ratio in predicting sPOPF (specificity: 97.6% vs. 86.0%; PPV: 62.5% vs. 23.1%). Conclusion: AVD on POD 3 is a more specific parameter than conventional amylase concentration ratio in predicting sPOPF.

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Multimodal Radiomic Features for the Predicting Gleason Score of Prostate Cancer

Cancers ◽

10.3390/cancers10080249 ◽

2018 ◽

Vol 10 (8) ◽

pp. 249 ◽

Cited By ~ 26

Author(s):

Ahmad Chaddad ◽

Michael Kucharczyk ◽

Tamim Niazi

Keyword(s):

Prostate Cancer ◽

Gleason Score ◽

Area Under The Curve ◽

Rank Correlation ◽

Biological Data ◽

Imaging Data ◽

Spearman’S Rank Correlation ◽

Intensity Matrix ◽

Apparent Diffusion ◽

Occurrence Matrix

Background: Novel radiomic features are enabling the extraction of biological data from routine sequences of MRI images. This study’s purpose was to establish a new model, based on the joint intensity matrix (JIM), to predict the Gleason score (GS) of prostate cancer (PCa) patients. Methods: A retrospective dataset comprised of the diagnostic imaging data of 99 PCa patients was used, extracted from The Cancer Imaging Archive’s (TCIA) T2-Weighted (T2-WI) and apparent diffusion coefficient (ADC) images. Radiomic features derived from JIM and the grey level co-occurrence matrix (GLCM) were extracted from the reported tumor locations. The Kruskal-Wallis test and Spearman’s rank correlation identified features related to the GS. The Random Forest classifier model was implemented to identify the best performing signature of JIM and GLCM radiomic features to predict for GS. Results: Five JIM-derived features: contrast, homogeneity, difference variance, dissimilarity, and inverse difference were independent predictors of GS (p < 0.05). Combined JIM and GLCM analysis provided the best performing area-under-the-curve, with values of 78.40% for GS ≤ 6, 82.35% for GS = 3 + 4, and 64.76% for GS ≥ 4 + 3. Conclusion: This retrospective study produced a novel predictive model for GS by the incorporation of JIM data from standard diagnostic MRI images.

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Evaluation of the clot burden score (cbs) for acute ischemic stroke (ais) in intent-to-treat patients.

Journal Of Cardiovascular, Neurovascular & Stroke ◽

10.32896/cvns.11.11-15 ◽

2019 ◽

pp. 11-15

Author(s):

Sarah Yaziz ◽

Ahmad Sobri Muda ◽

Wan Asyraf Wan Zaidi ◽

Nik Azuan Nik Ismail

Keyword(s):

Ischemic Stroke ◽

Clinical Outcome ◽

Acute Ischemic Stroke ◽

Predictive Value ◽

Area Under The Curve ◽

Rank Correlation ◽

Treatment Decision ◽

Roc Curves ◽

Significant Negative Correlation ◽

Clot Burden

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Predictive value of leukocyte telomere length for the severity of coronary artery disease

Personalized Medicine ◽

10.2217/pme-2019-0152 ◽

2020 ◽

Vol 17 (3) ◽

pp. 175-183

Author(s):

Ying Sun ◽

Jing-Qian Zhao ◽

Yue-Ru Jiao ◽

Jian Ren ◽

Yan-Hong Zhou ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Telomere Length ◽

Independent Predictor ◽

Area Under The Curve ◽

Rank Correlation ◽

Leukocyte Telomere Length ◽

Spearman’S Rank Correlation ◽

Spearman’S Rank Correlation Coefficient ◽

Artery Disease

Aim: This study aimed to explore leukocyte telomere length (LTL) in the prediction of the severity of coronary artery disease (CAD). Materials & methods: A total of 359 CAD patients who underwent coronary angiography were enrolled in this study. Severity of coronary artery was assessed by Gensini score (GS). Results: LTL is negatively correlated with GS (Spearman's rank correlation coefficient = -0.335; p < 0.001). Multivariate logistic regression results showed that LTL was an independent predictor of high GS (p = 0.001). Area under the curve value of LTL for predicting high GS was 0.659 (p < 0.001). Conclusion: LTL could be considered as a potential predictor of the severity of coronary artery in patients with CAD.

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Predictive performance of BI-RADS magnetic resonance imaging descriptors in the context of suspicious (category 4) findings

Radiologia Brasileira ◽

10.1590/0100-3984.2015.0021 ◽

2016 ◽

Vol 49 (3) ◽

pp. 137-143 ◽

Cited By ~ 10

Author(s):

João Ricardo Maltez de Almeida ◽

André Boechat Gomes ◽

Thomas Pitangueiras Barros ◽

Paulo Eduardo Fahel ◽

Mário de Seixas Rocha

Keyword(s):

Magnetic Resonance Imaging ◽

Multivariate Analysis ◽

Magnetic Resonance ◽

Roc Curve ◽

Breast Imaging ◽

Area Under The Curve ◽

Predictive Performance ◽

Resonance Imaging ◽

Significant Difference ◽

Mass Enhancement

Abstract Objective: To determine the positive predictive value (PPV) and likelihood ratio for magnetic resonance imaging (MRI) characteristics of category 4 lesions, as described in the Breast Imaging Reporting and Data System (BI-RADS®) lexicon, as well as to test the predictive performance of the descriptors using multivariate analysis and the area under the curve derived from a receiver operating characteristic (ROC) curve. Materials and Methods: This was a double-blind review study of 121 suspicious findings from 98 women examined between 2009 and 2013. The terminology was based on the 2013 edition of the BI-RADS. Results: Of the 121 suspicious findings, 53 (43.8%) were proven to be malignant lesions, with no significant difference between mass and non-mass enhancement (p = 0.846). The PPVs were highest for masses with a spiculated margin (71%) and round shape (63%), whereas segmental distribution achieved a high PPV (80%) for non-mass enhancement. Kinetic analyses performed poorly, except for type 3 curves applied to masses (PPV of 73%). Logistic regression models were significant for both patterns, although the results were better for masses, particularly when kinetic assessments were included (p = 0.015; pseudo R2 = 0.48; area under the curve = 90%). Conclusion: Some BI-RADS MRI descriptors have high PPV and good predictive performance-as demonstrated by ROC curve and multivariate analysis-when applied to BI-RADS category 4 findings. This may allow future stratification of this category.

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Correlation of 18F-FDG PET/MRE Metrics with Inflammatory Biomarkers in Patients with Crohn’s Disease: A Pilot Study

Contrast Media & Molecular Imaging ◽

10.1155/2017/7167292 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Liran Domachevsky ◽

Haim Leibovitzh ◽

Irit Avni-Biron ◽

Lev Lichtenstein ◽

Natalia Goldberg ◽

...

Keyword(s):

Crohn’S Disease ◽

Pilot Study ◽

Magnetic Resonance ◽

Crohn's Disease ◽

Fdg Pet ◽

Area Under The Curve ◽

Roc Curves ◽

Fecal Calprotectin ◽

Inflammatory Biomarkers ◽

18F Fdg

Background. To investigate the association between 18F-FDG (Fluorodeoxyglucose) PET (positron emission tomography)/MRE (magnetic resonance enterography) metrics with the inflammatory biomarkers fecal calprotectin and C-reactive protein (CRP) in patients with Crohn’s disease (CD). Methods. This prospective pilot study was institutional review board (IRB) approved with informed consent obtained. Consecutive CD patients were referred to 18F-FDG PET/MRE. Patients in whom colonoscopy was performed and CRP and fecal calprotectin levels were measured were included. CRP and fecal calprotectin were regarded as positive for inflammation if they were greater than 0.5 mg/dl and 150 mcg/g, respectively. Correlation of quantitative variables was performed using the Pearson’s correlation coefficient. Receiver operating characteristic (ROC) curves were drawn and the area under the curve (AUC) was calculated to evaluate the accuracy of PET and MRE metrics in determining the presence of inflammation evaluated by calprotectin and CRP levels. Results. Analysis of 21 patients (16 women and 5 men, 43±18 years) was performed. Magnetic resonance index of activity (MaRIA) score had an AUC of 0.63 associated with fecal calprotectin and CRP. Adding apparent diffusion coefficient (ADC) and metabolic inflammatory volume (MIV) to MaRIA score resulted in an AUC of 0.92 with a cutoff value of 447 resulting in 83% and 100% sensitivity and specificity, respectively. Conclusion. The addition of ADC and MIV to the MaRIA score increases the accuracy for discrimination of disease activity in patients with CD. Trial registration number is 2015062.

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