MRI may be able to identify the origin of neuroendocrine tumor liver metastases

2020 ◽  
Author(s):  
Maxime Barat ◽  
Philippe Soyer ◽  
Fatima Al Sharhan ◽  
Benoit Terris ◽  
Ammar Oudjit ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Neuroendocrine Tumors ◽  
Interobserver Agreement ◽  
Validation Cohort ◽  
Univariate Analysis ◽  
Intraclass Correlation ◽  
Hepatic Metastases ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Objectives: To discriminate hepatic metastases from pancreatic neuroendocrine tumors (pNET) and hepatic metastases from midgut neuroendocrine tumors (mNET) with magnetic resonance imaging (MRI). Methods: MRI examinations of 24 patients with hepatic metastases from pNET were quantitatively and qualitatively assessed by two blinded readers and compared to those obtained in 23 patients with hepatic metastases from mNET. Inter-reader agreement was calculated with kappa and intraclass correlation coefficient (ICC). Sensitivity, specificity and accuracy of each variable for the diagnosis of hepatic metastasis from pNET were calculated. Associations between variables and primary tumor (i.e., pNET vs. mNET) were assessed at univariate and multivariate analysis. A nomogram was developed and validated using an external cohort of 20 patients with pNET and 20 patients with mNET. Results: Interobserver agreement was strong to perfect (k=0.893-1) for qualitative criteria and excellent for quantitative variables (ICC: 0.9817-0.9996). At univariate analysis, homogeneity on T1-weighted images was the most discriminating variable for the diagnosis of pNET (OR, 6.417; P=0.013) with greatest sensitivity (88%; 21/24; 95% CI: 68-97%). At multivariate analysis, tumor homogeneity on T1-weighted images (P=0.007; OR, 17.607; 95%CI: 2.179–142.295) and target sign on DW images (P=0.007; OR, 19.869; 95%CI: 2.305–171.276) were independently associated with pNET. Nomogram yielded a corrected AUC of 0.894 (95%CI: 0.796–0.992) for the diagnosis of pNET in the training cohort and 0.805 (95%CI: 0.662–0.948) in the validation cohort. Conclusions: MRI provides qualitative features that can help discriminate between hepatic metastases from pNET and those from mNET.

scholarly journals Vancouver B and C periprosthetic fractures around the cemented Exeter Stem: sex is associate with fracture pattern

2021 ◽  
Author(s):  
M. F. R. Powell-Bowns ◽  
E. Oag ◽  
D. Martin ◽  
N. D. Clement ◽  
C. E. H. Scott
Keyword(s):  
Multivariate Analysis ◽  
Interobserver Reliability ◽  
Univariate Analysis ◽  
Intraclass Correlation ◽  
Cement Mantle ◽  
Mantle Length ◽  
Periprosthetic Fractures ◽  
Stem Design ◽  
Female Sex ◽  
Radiographic Measurements

Abstract Introduction The aim of this study was to identify factors associated with the level of periprosthetic fracture involving a cemented polished tapered stem: Vancouver B or Vancouver C. Methods A retrospective cohort study of 181 unilateral periprosthetic fractures involving Exeter stems was assessed by three observers (mean age 78.5, range 39–103; mean BMI 27.1, 17–39; 97 (54%) male). Patient demographics, deprivation scores, BMI and time since primary prosthesis were recorded. Femoral diameter, femoral cortical thickness, Dorr classification and distal cement mantle length were measured from calibrated radiographs. Interobserver reliability was calculated using intraclass correlation coefficients (ICCs). Univariate and multivariate analysis was performed to identify associations with Vancouver B or C fractures. Results 160/181 (88%) Vancouver B and 21/181 (12%) Vancouver C-level fractures occurred at a mean of 5.9 ± 5.4 years (0.2–26.5) following primary surgery. Radiographic measurements demonstrated excellent agreement (ICC > 0.8, p < 0.001). Mortality was significantly higher following Vancouver C compared to B fractures: 90 day 14/160 Vs 5/21 (p = 0.05); 1 year 29/160 Vs 8/21 (p = 0.03). Univariate analysis demonstrated that Vancouver C fractures were associated with female sex, bisphosphonate use, cortical bone thickness, and distal cement mantle length (p < 0.05). On multivariate analysis, only female sex was an independent predictor of Vancouver C-level fractures (R2 =0.354, p = 0.005). Conclusion Most PFFs involving the Exeter stem design are Vancouver B-type fractures and appear to be independent of osteoporosis. In contrast, Vancouver C periprosthetic fractures display typical fragility fracture characteristics and are associated with female sex, thinner femoral cortices, longer distal cement mantles and high mortality.

Agreement between magnetic resonance imaging, myelography, and surgery for detecting recurrent, thoracolumbar intervertebral disc extrusion in dogs

2013 ◽  
Vol 26 (01) ◽  
pp. 12-18 ◽  
Author(s):  
B. A. Brisson ◽  
S. G. Nykamp ◽  
D. Reynolds
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Intervertebral Disc ◽  
Interobserver Agreement ◽  
Surgical Decompression ◽  
Diagnostic Methods ◽  
Resonance Imaging ◽  
Disc Disease ◽  
Recurrent Lesion ◽  
Magnetic Resonance Imaging Mri

Summary Objectives: Although magnetic resonance imaging (MRI) is reported to be superior to myelography to determine the location and site of first time disc herniation, comparison of these diagnostic methods in cases of recurrent intervertebral disc disease (IVD) herniation after a first surgery has not been evaluated. The objective was to compare the diagnostic accuracy of MRI and myelography in a series of dogs undergoing repeat surgical decompression for recurrent IVD extrusion when compared to the gold standard of surgery. Methods: Ten dogs with recurrent IVD herniation underwent MRI and myelography followed by surgical decompression. Three observers reviewed the images to determine the site and side of the first surgery and the recurrent lesion. Agreement was determined by calculating a kappa (κ) score. Results: Substantial interobserver agreement was noted for recurrent lesion site using MRI and myelography (κ = 0.77 vs. 0.73) and when comparing MRI and myelography to the reported surgical site (κ = 0.73 vs. 0.67). Interobserver agreement was greater with MRI for circumferential location compared to myelography (κ = 0.76 vs. 0.43), similar to what was found when comparing to surgical side (κ = 0.82 vs. 0.49). The previous surgical site in this study had no effect on ability to identify the new lesion. Clinical significance: Despite the limitations of MRI, there was greater agreement between observers using MRI for both the recurrent and first lesion.

scholarly journals Percutaneous ultrasound guided radiofrequency and microwave ablation in the treatment of hepatic metastases. A monocentric initial experience.

2019 ◽  
Vol 21 (3) ◽  
pp. 217 ◽  
Author(s):  
Zeno Sparchez ◽  
Tudor Mocan ◽  
Nadim All Hajjar ◽  
Adrian Bartos ◽  
Claudia Hagiu ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Microwave Ablation ◽  
Univariate Analysis ◽  
Hepatic Metastases ◽  
Tumor Ablation ◽  
Tumor Control ◽  
Local Tumor ◽  
Long Term Outcome ◽  
Significant Difference ◽  
Multiple Metastases

Aim: Percutaneous radiofrequency (RFA) and microwave ablation (MWA) are currently the best treatment options forpatients with liver metastases (LM) who cannot undergo a liver resection procedure. Presently, few studies have evaluated theefficacy of tumor ablation in beginner’s hands but none at all in hepatic metastasis. Our aim was to report the initial experiencewith ultrasound as a tool to guide tumor ablation in a low volume center with no experience in tumor ablation.Material and methods: We conducted a retrospective cohort study, on a series of 61 patients who had undergone percutaneous US-guided ablations for 82 LM between 2010 and 2015. Long term outcome predictors were assessed using univariate and multivariate analysis.Results: Complete ablation was achieved in 86.9% of cases (53/61). All MWA sessions (20/20) attained ablation margins >5mm, compared to 79% (49/62) for RFA sessions (p=0.031). Ablation time was significantly shorter for MWA, with a median duration of 10 minutes (range: 6-12) vs. 14 minutes (range: 10-19.5, p=0.003). There was no statistically significant difference in local tumor progression (LTP)-free survival rates between MWA and RFA (p=0.154). On univariate analysis, significant predictors for local recurrence were multiple metastases (p=0.013) and ablation margins <5 mm (p<.001), both retaining significance on multivariate analysis. Significant predictors for distant recurrence on both univariate and multivariate analysis were multiple metastases (p<0.001) and non-colorectal cancer metastases (p<0.05).Conclusion: A larger than 5 mm ablation size is critical for local tumor control. We favor the use of MWA due to its ability to achieve ablation in significantlyshorter times with less incomplete ablations.

scholarly journals Evaluation of the Usefulness of CO-RADS for Chest CT in Patients Suspected of Having COVID-19

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 608 ◽  
Author(s):  
Tomoyuki Fujioka ◽  
Marie Takahashi ◽  
Mio Mori ◽  
Junichi Tsuchiya ◽  
Emi Yamaga ◽  
...  
Keyword(s):  
Interobserver Agreement ◽  
Characteristic Curve ◽  
Intraclass Correlation ◽  
Ct Images ◽  
Chest Ct ◽  
Rt Pcr ◽  
Radiological Society ◽  
Significant Difference ◽  
The Individual ◽  
Sensitivity Specificity

The purpose of this study was to use the Coronavirus Disease 2019 (COVID-19) Reporting and Data System (CO-RADS) to evaluate the chest computed tomography (CT) images of patients suspected of having COVID-19, and to investigate its diagnostic performance and interobserver agreement. The Dutch Radiological Society developed CO-RADS as a diagnostic indicator for assessing suspicion of lung involvement of COVID-19 on a scale of 1 (very low) to 5 (very high). We investigated retrospectively 154 adult patients with clinically suspected COVID-19, between April and June 2020, who underwent chest CT and reverse transcription-polymerase chain reaction (RT-PCR). The patients’ average age was 61.3 years (range, 21–93), 101 were male, and 76 were RT-PCR positive. Using CO-RADS, four radiologists evaluated the chest CT images. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were calculated. Interobserver agreement was calculated using the intraclass correlation coefficient (ICC) by comparing the individual reader’s score to the median of the remaining three radiologists. The average sensitivity was 87.8% (range, 80.2–93.4%), specificity was 66.4% (range, 51.3–84.5%), and AUC was 0.859 (range, 0.847–0.881); there was no significant difference between the readers (p > 0.200). In 325 (52.8%) of 616 observations, there was absolute agreement among observers. The average ICC of readers was 0.840 (range, 0.800–0.874; p < 0.001). CO-RADS is a categorical taxonomic evaluation scheme for COVID-19 pneumonia, using chest CT images, that provides outstanding performance and from substantial to almost perfect interobserver agreement for predicting COVID-19.

scholarly journals Magnetic resonance imaging based coracoid morphology and its associations with subscapularis tears: a new index

2017 ◽  
Vol 11 (1_suppl) ◽  
pp. 52-58 ◽  
Author(s):  
Adam C. Watson ◽  
Richard P. Jamieson ◽  
Andrew C. Mattin ◽  
Richard S. Page
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Sagittal Plane ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Resonance Imaging ◽  
Intraclass Correlation Coefficients ◽  
Arm Position ◽  
Magnetic Resonance Imaging Mri

Background We aimed to assess the validity of magnetic resonance imaging (MRI) in assessing the subcorocoid space and determine the validity of novel sagittal plane subcorocoid space measurements. Methods We assessed 33 arthroscopically proven subscapularis tears with MRIs compared to 33 (instability) controls with normal subscapularis tendons. Three examiners analyzed MRIs for seven static indices of corocoid morphology, in axial and sagittal planes. We explored reviewer variation using intraclass correlation coefficients (ICC) and differences between the two groups was explored using t-tests. Results Groups were similar in characteristics but different in age (cases = 53, controls = 23). ICC showed good (2/7) or excellent (5/7) reliability. Small differences(<1.6 mm) were identified between subscapularis tears and controls in coraco–humeral distance, in axial ( p = 0.092) and sagittal planes ( p = 0.045). There were statistically significant differences between groups when analyzing the angular projection of the coracoid from the glenoid, in both sagittal ( p < 0.0001) and axial planes ( p = 0.045). Conclusions Acute inferior angulation of the corocoid in the sagittal plane may be associated with subscapularis tears. Static indices are measured within the scapula and not affected by arm position. MRI reliably provided a platform to assess the coracoid. Based on this, we currently consider corocoplasty in patients with subscapularis tears and a sagittal coroco–glenoid angle <60o to reduce potential impingement.

scholarly journals Interobserver agreement for detecting Hill-Sachs lesions on magnetic resonance imaging

2021 ◽  
Vol 24 (2) ◽  
pp. 98-105
Author(s):  
Hassanin Alkaduhimi ◽  
Aïmane Saarig ◽  
Ihsan Amajjar ◽  
Just A. van der Linde ◽  
Marieke F. van Wier ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Interobserver Agreement ◽  
Interobserver Reliability ◽  
Patient Characteristics ◽  
Accurate Diagnosis ◽  
Bonferroni Correction ◽  
Resonance Imaging ◽  
Similar Appearance ◽  
Magnetic Resonance Imaging Mri

Background: Our aim is to determine the interobserver reliability for surgeons to detect Hill-Sachs lesions on magnetic resonance imaging (MRI), the certainty of judgement, and the effects of surgeon characteristics on agreement. Methods: Twenty-nine patients with Hill-Sachs lesions or other lesions with a similar appearance on MRIs were presented to 20 surgeons without any patient characteristics. The surgeons answered questions on the presence of Hill-Sachs lesions and the certainty of diagnosis. Interobserver agreement was assessed using the Fleiss’ kappa (κ) and percentage of agreement. Agreement between surgeons was compared using a technique similar to the pairwise t-test for means, based on large-sample linear approximation of Fleiss' kappa, with Bonferroni correction. Results: The agreement between surgeons in detecting Hill-Sachs lesions on MRI was fair (69% agreement; κ, 0.304; p<0.001). In 84% of the cases, surgeons were certain or highly certain about the presence of a Hill-Sachs lesion. Conclusions: Although surgeons reported high levels of certainty for their ability to detect Hill-Sachs lesions, there was only a fair amount of agreement between surgeons in detecting Hill-Sachs lesions on MRI. This indicates that clear criteria for defining Hill-Sachs lesions are lacking, which hampers accurate diagnosis and can compromise treatment.

scholarly journals Magnetic resonance imaging in the diagnosis of nonpalpable breast cancer

2017 ◽  
Vol 98 (1) ◽  
pp. 34-37
Author(s):  
S S Vatankha ◽  
S A Saryev
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Breast Ultrasound ◽  
Resonance Imaging ◽  
Old Patients ◽  
Nonpalpable Lesions ◽  
Nonpalpable Breast Cancer ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Aim. To analyze sensitivity of magnetic resonance imaging (MRI) in the diagnosis of breast cancer when used after mammography and breast ultrasound.Methods. The study included 70 patients with nonpalpable breast lesions who had changes of breast tissue found at previous studies (mammography and breast ultrasound). MRI was performed with the use of Siemens Magnetom Avanto with magnetic field 1.5 Tl.Results. Most frequently nonpalpable lesions were diagnosed in 45 to 60-year old patients (60%), a little rarer - in 39 to 45-year old patients (22.9%), in patients at the age of 61 to 69 - in 10.0% (7 patients). 7.1% patients were over 70. All first detected nonpalpable lesions of breast were biopsied for morphological verification. With the combined use of mammography, sonography, MRI and stereotactic biopsy the diagnosis was made in 100% patients. MRI with contract enhancement showed no relation between sensitivity, specificity and reliability and density of breast tissues.Conclusions. MRI is considered a highly sensitive method of diagnosis and identification of changes found at mammography and breast ultrasound.

scholarly journals T2 Hypointensity Aids in the Diagnosis of Intracranial Metastatic Adenocarcinoma

2019 ◽  
Vol 47 (2) ◽  
pp. 210-213 ◽  
Author(s):  
Khunsa Faiz ◽  
Alex Botsford ◽  
Namita Sinha ◽  
Simon Walling ◽  
Jai Jai Shiva Shankar
Keyword(s):  
Predictive Value ◽  
Odds Ratio ◽  
High Specificity ◽  
Qualitative Assessment ◽  
Resonance Imaging ◽  
Metastatic Brain Tumors ◽  
Intracranial Metastasis ◽  
Normal Appearing White Matter ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

ABSTRACT:Background:The T2 hypointensity has been suggested to be associated with intracranial metastatic adenocarcinomas (IMA). The purpose of our study was to determine the association of T2 hypointensity with IMA.Methods:All patients with pathologically confirmed metastatic brain tumors who had a magnetic resonance imaging (MRI) at our institution in the last 10 years were retrospectively assessed. Qualitative assessment of the lesions on MRI was done by two separate readers who were blinded to the pathological diagnosis. For qualitative assessment, the T2 hypointensity in the lesion was compared with the contralateral normal appearing white matter. Odds ratio, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.Results:Of 107 patients with intracranial metastasis, only 73 (40 females; 33 males; mean age 61 years) had MRI available for review. Of these, only 46 (25 females; 21 males; mean age 61 years) had pathologically proven IMA. T2 hypointensity was seen in 20% of IMA. The odds ratio of T2 hypointensity in IMA was 3 compared to nonadenocarcinomas but was not statistically significant (p = 0.16). Intralesional hemorrhage was seen in 20. When controlled for hemorrhage, the odds ratio for T2 hypointensity in IMA was 4.7. The specificity, sensitivity, PPV, and NPV for T2 hypointensity to diagnose IMA were 92%, 19%, 81%, and 40%, respectively.Conclusion:T2 hypointensity was seen only in 20% of IMA with an odds ratio of 4.7. T2 hypointensity showed a high specificity and PPV for diagnosis of IMA.

Diagnostic accuracy of B-scan in predicting retinoblastoma in children, taking Magnetic Resonance Imaging of orbits as gold standard

2020 ◽  
pp. 1-7
Author(s):  
Saba Murad ◽  
Ishtiaq Ahmed ◽  
Hania Ali ◽  
Maria Ghani ◽  
Sana Murad
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Radiology Department ◽  
Inclusion Criteria ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Abstract The objective of this study was to determine the diagnostic accuracy of B-scan in predicting retinoblastoma (Rb) taking Magnetic Resonance Imaging (MRI) as a gold standard. A cross-sectional validation study was conducted in the Radiology Department of Fauji Foundation Hospital from  May 20 to Nov 20, 2017. Children fulfilling the inclusion criteria were selected after informed consent and detailed history was taken for investigation of Rb. B-scan of both eyes was done using 7.5-10 MHz probe, followed by MRI of both eyes in the same patients using 1.5 Tesla MRI machine with the help of qualified MRI technicians. Data analysis was done by SPSS version 16.0. The diagnostic accuracy, sensitivity, specificity, PPV and NPV of B-scan in prediction of Rb as compared to MRI was 90.45%, 82.28%, 90.54% and 90.28% respectively. The study concluded that diagnostic accuracy of B-scan as compared to MRI is substantial in Retinoblastoma. Continuous...

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