MRIs and the Perception of Risk

2007 ◽  
Vol 33 (2-3) ◽  
pp. 229-237 ◽  
Author(s):  
Steven Goldberg
Keyword(s):  
Magnetic Resonance ◽  
Public Perception ◽  
Health And Safety ◽  
Research Subjects ◽  
Perception Of Risk ◽  
Medical Diagnoses ◽  
Important Health ◽  
Clinically Significant ◽  
Magnetic Resonance Imaging Mri ◽  
The One

The most important safety decision concerning MRIs was to change the name of the procedure. In the late 1970s, the procedure known as nuclear magnetic resonance (NMR) became magnetic resonance imaging (MRI) because of the negative connotations the word “nuclear” invited. Since then, the use of MRIs has flourished. The procedure is now routinely conducted to make medical diagnoses and to study the brain functioning of healthy volunteers participating in research studies devised by, among others, neuroscientists and economists.There is nothing intrinsically wrong with changing a procedure's name to respond to a public perception of risk, especially when experts do not share that perception. Yet, while MRIs rarely injure patients or test subjects, there is reason to believe that they have important health and safety consequences not captured in standard informed consent forms. These concerns ironically involve perception of risk. On the one hand, unexpected incidental findings of clinically significant conditions in volunteer research subjects raise a host of ethical concerns.

Prostate Magnetic Resonance Imaging: Lesion Detection and Local Staging

2019 ◽  
Vol 70 (1) ◽  
pp. 451-459 ◽  
Author(s):  
Baris Turkbey ◽  
Peter L. Choyke
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Lesion Detection ◽  
Lower Sensitivity ◽  
Resonance Imaging ◽  
Prostate Mri ◽  
Local Staging ◽  
Clinically Significant ◽  
Magnetic Resonance Imaging Mri ◽  
Indolent Disease

Dramatic changes in the use of prostate magnetic resonance imaging (MRI) have occurred in the last decade. The recognition that MRI detects and localizes cancers with reasonable accuracy led to the development of directed biopsies. These image-guided biopsies have a higher sensitivity for clinically significant cancers and a lower sensitivity for indolent disease. Prospective trials provide level 1 evidence supporting the use of prostate MRI. For local staging, while the specificity of prostate MRI is high, its sensitivity is lacking for microscopic extraprostatic extension. Computer-aided diagnosis of prostate MRI promises to bring the diagnostic power of MRI to nonexpert readers and thus further integrate MRI into the diagnostic workup.

Comparison of spinal magnetic resonance imaging and myelography in cancer patients.

1987 ◽  
Vol 5 (10) ◽  
pp. 1663-1669 ◽  
Author(s):  
C Hagenau ◽  
W Grosh ◽  
M Currie ◽  
R G Wiley
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cancer Patients ◽  
Imaging Modality ◽  
Radicular Pain ◽  
Surface Coil ◽  
Resonance Imaging ◽  
Spinal Magnetic Resonance Imaging ◽  
Clinically Significant ◽  
Magnetic Resonance Imaging Mri

Spinal involvement by systemic malignancy is common, and often leads to extradural compression of the spinal cord and/or nerve roots by metastases. Rapid, anatomically accurate diagnosis is essential to the successful management of these patients. We compared spinal magnetic resonance imaging (MRI) with conventional myelography in a series of 31 cancer patients being evaluated for myelopathy (N = 10), or back/radicular pain (N = 21). All patients were evaluated between April 1985 and July 1986, and underwent both studies within ten days of each other (median, two days). MRI was performed on a 0.5 Tesla Technicare unit with a body surface coil, and results compared with standard contrast myelography. All studies were reviewed separately and in a "blinded" fashion. MRI and myelography were comparable in detecting large lesions that produced complete subarachnoid block (five of ten patients with myelopathy, three of twenty-one patients with back/radicular pain). In 19 of 31 patients, smaller but clinically significant extradural lesions were found. In nine of 19 cases, these lesions were demonstrated equally well by both modalities; in nine of 19 cases, these lesions were demonstrated by myelography alone; in one of 19, a lesion was demonstrated by MRI alone. Given our current technology, myelography appeared superior to MRI as a single imaging modality. However, MRI may be an alternative in patients where total myelography is technically impossible or unusually hazardous.

Enhanced magnetic resonance imaging in multiple sclerosis

2000 ◽  
Vol 6 (5) ◽  
pp. 320-326 ◽  
Author(s):  
M Filippi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Tissue Loss ◽  
Resonance Imaging ◽  
The Past ◽  
Magnetic Resonance Imaging Mri ◽  
The One ◽  
The Relationship

Gadolinium-enhanced magnetic resonance imaging (MRI) is very sensitive in the detection of active lesions of multiple sclerosis (MS) and has become a valuable tool to monitor the evolution of the disease either natural or modified by treatment. In the past few years, several studies, on the one hand, have assessed several ways to increase the sensitivity of enhanced MRI to disease activity and, on the other, have investigated in vivo the nature and evolution of enhancing lesions using different non-conventional MR techniques to better define the relationship between enhancement and tissue loss in MS. The present review is a summary of these studies whose results are discussed in the context of MS clinical trial planning and monitoring.

scholarly journals Prediction Medicine: Biomarkers, Risk Calculators and Magnetic Resonance Imaging as Risk Stratification Tools in Prostate Cancer Diagnosis

2019 ◽  
Vol 20 (7) ◽  
pp. 1637 ◽  
Author(s):  
Daniël Osses ◽  
Monique Roobol ◽  
Ivo Schoots
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Risk Stratification ◽  
Resonance Imaging ◽  
Diagnostic Strategies ◽  
Novel Biomarkers ◽  
Clinically Significant ◽  
Magnetic Resonance Imaging Mri ◽  
Prostate Health

This review discusses the most recent evidence for currently available risk stratification tools in the detection of clinically significant prostate cancer (csPCa), and evaluates diagnostic strategies that combine these tools. Novel blood biomarkers, such as the Prostate Health Index (PHI) and 4Kscore, show similar ability to predict csPCa. Prostate cancer antigen 3 (PCA3) is a urinary biomarker that has inferior prediction of csPCa compared to PHI, but may be combined with other markers like TMPRSS2-ERG to improve its performance. Original risk calculators (RCs) have the advantage of incorporating easy to retrieve clinical variables and being freely accessible as a web tool/mobile application. RCs perform similarly well as most novel biomarkers. New promising risk models including novel (genetic) markers are the SelectMDx and Stockholm-3 model (S3M). Prostate magnetic resonance imaging (MRI) has evolved as an appealing tool in the diagnostic arsenal with even stratifying abilities, including in the initial biopsy setting. Merging biomarkers, RCs and MRI results in higher performances than their use as standalone tests. In the current era of prostate MRI, the way forward seems to be multivariable risk assessment based on blood and clinical parameters, potentially extended with information from urine samples, as a triaging test for the selection of candidates for MRI and biopsy.

scholarly journals Clinically relevant magnetic resonance imaging (MRI) findings in elite swimmers’ shoulders

2017 ◽  
Vol 21 (1) ◽  
Author(s):  
Arno Celliers ◽  
Fekade Gebremariam ◽  
Gina Joubert ◽  
Thami Mweli ◽  
Husain Sayanvala ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Shoulder Function ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Ac Joint ◽  
Elite Swimmers ◽  
Clinically Significant ◽  
Magnetic Resonance Imaging Mri ◽  
Common Clinical Finding

Background: Shoulder pain is the most common and well-documented site of musculoskeletal pain in elite swimmers. Structural abnormalities on magnetic resonance imaging (MRI) of elite swimmers’ symptomatic shoulders are common. Little has been documented about the association between MRI findings in the asymptomatic shoulder versus the symptomatic shoulder.Objective: To assess clinically relevant MRI findings in the shoulders of symptomatic and asymptomatic elite swimmers.Method: Twenty (aged 16–23 years) elite swimmers completed questionnaires on their swimming training, pain and shoulder function. MRI of both shoulders (n = 40) were performed and all swimmers were given a standardised clinical shoulder examination. Results: Both shoulders of 11 male and 9 female elite swimmers (n = 40) were examined. Eleven of the 40 shoulders were clinically symptomatic and 29 were asymptomatic. The most common clinical finding in both the symptomatic and asymptomatic shoulders was impingement during internal rotation, with impingement in 54.5% of the symptomatic shoulders and in 31.0% of the asymptomatic shoulders. The most common MRI findings in the symptomatic and asymptomatic shoulders were supraspinatus tendinosis (45.5% vs. 20.7%), subacromial subdeltoid fluid (45.5% vs. 34.5%), increased signal in the AC Joint (45.5% vs. 37.9%) and AC joint arthrosis (36.4% vs. 34.5%). Thirty-nine (97.5%) of the shoulders showed abnormal MRI features.Conclusion: MRI findings in the symptomatic and asymptomatic shoulders of young elite swimmers are similar and care should be taken when reporting shoulder MRIs in these athletes. Asymptomatic shoulders demonstrate manifold MRI abnormalities that may be radiologically significant but appear not to be clinically significant.

Magnetic resonance imaging screening for vestibular schwannoma: analysis of published protocols

2004 ◽  
Vol 118 (5) ◽  
pp. 329-332 ◽  
Author(s):  
R. J. Obholzer ◽  
P. A. Rea ◽  
J. P. Harcourt
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Vestibular Schwannoma ◽  
Resonance Imaging ◽  
Patient Anxiety ◽  
Interaural Difference ◽  
Magnetic Resonance Imaging Mri ◽  
Magnetic Resonance Imaging Screening ◽  
The One ◽  
Year 2000

This study seeks to define the most appropriate guidelines for selection of patients for magnetic resonance imaging (MRI) to exclude a vestibular schwannoma. Improved selection may reduce patient anxiety and improve resource utilization.All MRIs of the internal auditory meatus, performed during the year 2000, were reviewed. Audiograms and symptoms were collated for all ’positive’ scans and 100 negative scans. Information was analysed using seven published protocols and other defined frequency specific criteria.A diagnosis of vestibular schwannoma was made on 36 scans. Four criteria had a sensitivity of >95 per cent; of these the highest specificity (49 per cent) utilized an interaural difference at two adjacent frequencies of 15.dB in unilateral hearing loss and 20.dB in bilateral asymmetric loss.Applying our best protocol would have reduced the number of scans performed from 392 to 168. The one patient with a vestibular schwannoma who was excluded had trigeminal paraesthesia, an independent indication for investigation.

Magnetic Resonance Imaging in the Diagnosis and Treatment of Lhermitte-Duclos Disease (Dysplastic Gangliocytoma of the Cerebellum)

Neurosurgery ◽  
1988 ◽  
Vol 23 (2) ◽  
pp. 240-245 ◽  
Author(s):  
Ralph F. Reeder ◽  
Richard L. Saunders ◽  
David W. Roberts ◽  
Jonathan D. Fratkin ◽  
Laurence D. Cromwell
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
High Probability ◽  
Residual Tumor ◽  
Resonance Imaging ◽  
Dysplastic Gangliocytoma ◽  
First Case ◽  
Clinically Significant ◽  
Magnetic Resonance Imaging Mri ◽  
Significant Mass

ABSTRACT Lhermitte-Duclos disease is a rare disorder characterized by a slowly enlarging mass lesion in the cerebellum. The pathophysiology of the disease is poorly understood, but recent reports have suggested that a clinically significant mass may recur many years after total gross removal of the tumor. Computed tomography and angiography have been relatively insensitive in imaging the tumor either at presentation or during the postoperative period. The authors present three patients with histologically proven Lhermitte-Duclos disease who have undergone magnetic resonance imaging (MRI). In the first case, preoperative T1- and T2-weighted images clearly demonstrated the location and extent of the lesion, which was verified at operation. In the other two cases, only postoperative images were obtained. These demonstrated the extent of residual tumor and indicate a high probability of lesion expansion during periods of 4 and 10 years, respectively. We conclude that MRI is an important tool in both the diagnosis and the treatment of patients with Lhermitte-Duclos disease.

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