scholarly journals Combined Amino Acid Pet-Mri for Differentiating Recurrence from Radiation Necrosis in Gliomas- Together We Grow

2021 ◽  
Author(s):  
Shumyla Jabeen ◽  
Arpana Arbind ◽  
Dinesh Kumar ◽  
Pardeep kumar Singh ◽  
Jitender Saini ◽  
...  
Keyword(s):  
Amino Acid ◽  
Diagnostic Accuracy ◽  
Diagnostic Performance ◽  
Radiation Necrosis ◽  
Final Diagnosis ◽  
Post Treatment ◽  
Mr Perfusion ◽  
Spatial Concordance ◽  
Amino Acid Pet ◽  
And Diffusion

Abstract PURPOSE: To compare the diagnostic accuracy of amino acid PET, MR perfusion and diffusion as stand-alone modalities and in combination in differentiating recurrence from radiation necrosis in post-treatment gliomas and to qualitatively assess spatial concordance between the three modalities using simultaneous PET-MR acquisition.METHODS: A retrospective review of 48 cases of post-treatment gliomas who underwent simultaneous PET-MRI using C11 Methionine as radiotracer was performed. MR perfusion and diffusion sequences were acquired during the PET study. The following parameters were obtained: TBRmax, TBRmean, SUVmax and SUVmean from the PET images, rCBV from perfusion, ADCmean and ADCratio from the diffusion images. The final diagnosis was based on clinical/imaging follow-up and histopathology when available. ROC curve analysis in combination with logistic regression analysis was used to compare the diagnostic performance. Spatial concordance between modalities was graded as 0,1 and 2 representing discordance, <50% and >50% concordance respectively.RESULTS: There were 35 cases of recurrence and 13 cases of radiation necrosis. The highest area under curve(AUC) was obtained for TBRmax followed by rCBV and ADCratio. The AUC increased significantly with a combination of rCBV and TBRmax. Amino acid PET showed the highest diagnostic accuracy and maximum agreement with the final diagnosis. There was discordance between ADC and PET in 22.9%, between rCBV and PET in 16.7% and between PET and contrast enhancement in 14.6% cases.CONCLUSIONAmino acid PET had the highest diagnostic accuracy in differentiating radiation necrosis from recurrence. Combination of PET with MRI further increased the AUC thus improving the diagnostic performance.

scholarly journals Combined amino acid PET-MRI for identifying recurrence in post-treatment gliomas: together we grow

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Shumyla Jabeen ◽  
Arpana Arbind ◽  
Dinesh Kumar ◽  
Pardeep Kumar Singh ◽  
Jitender Saini ◽  
...  
Keyword(s):  
Amino Acid ◽  
Diagnostic Accuracy ◽  
Diagnostic Performance ◽  
Final Diagnosis ◽  
Post Treatment ◽  
Mr Perfusion ◽  
Roc Curve Analysis ◽  
Spatial Concordance ◽  
Amino Acid Pet ◽  
And Diffusion

Abstract Purpose The aim of this study is to compare the diagnostic accuracy of amino acid PET, MR perfusion and diffusion as stand-alone modalities and in combination in identifying recurrence in post-treatment gliomas and to qualitatively assess spatial concordance between the three modalities using simultaneous PET-MR acquisition. Methods A retrospective review of 48 cases of post-treatment gliomas who underwent simultaneous PET-MRI using C11 methionine as radiotracer was performed. MR perfusion and diffusion sequences were acquired during the PET study. The following parameters were obtained: TBRmax, TBRmean, SUVmax, and SUVmean from the PET images; rCBV from perfusion; and ADCmean and ADCratio from the diffusion images. The final diagnosis was based on clinical/imaging follow-up and histopathology when available. ROC curve analysis in combination with logistic regression analysis was used to compare the diagnostic performance. Spatial concordance between modalities was graded as 0, 1, and 2 representing discordance, < 50% and > 50% concordance respectively. Results There were 35 cases of recurrence and 13 cases of post-treatment changes without recurrence. The highest area under curve (AUC) was obtained for TBRmax followed by rCBV and ADCratio. The AUC increased significantly with a combination of rCBV and TBRmax. Amino acid PET showed the highest diagnostic accuracy and maximum agreement with the final diagnosis. There was discordance between ADC and PET in 22.9%, between rCBV and PET in 16.7% and between PET and contrast enhancement in 14.6% cases. Conclusion Amino acid PET had the highest diagnostic accuracy in identifying recurrence in post-treatment gliomas. Combination of PET with MRI further increased the AUC thus improving the diagnostic performance.

Assessing the Performance of a Novel Point-of-Care Qualitative Assay for Early Diagnosis of Acute Coronary Syndrome

Cardiology ◽  
2020 ◽  
pp. 1-8
Author(s):  
Ronny Alcalai ◽  
Boris Varshisky ◽  
Ahmad Marhig ◽  
David Leibowitz ◽  
Larissa Kogan-Boguslavsky ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Diagnostic Accuracy ◽  
Diagnostic Performance ◽  
Troponin I ◽  
Point Of Care ◽  
Final Diagnosis ◽  
Cardiac Biomarkers ◽  
Fatty Acid Binding ◽  
Coronary Syndrome

<b><i>Background:</i></b> Early and accurate diagnosis of acute coronary syndrome (ACS) is essential for initiating lifesaving interventions. In this article, the diagnostic performance of a novel point-of-care rapid assay (SensAheart<sup>©</sup>) is analyzed. This assay qualitatively determines the presence of 2 cardiac biomarkers troponin I and heart-type fatty acid-binding protein that are present soon after onset of myocardial injury. <b><i>Methods:</i></b> We conducted a prospective observational study of consecutive patients who presented to the emergency department with typical chest pain. Simultaneous high-sensitive cardiac troponin T (hs-cTnT) and SensAheart testing was performed upon hospital admission. Diagnostic accuracy was computed using SensAheart or hs-cTnT levels versus the final diagnosis defined as positive/negative. <b><i>Results:</i></b> Of 225 patients analyzed, a final diagnosis of ACS was established in 138 patients, 87 individuals diagnosed with nonischemic chest pain. In the overall population, as compared to hs-cTnT, the sensitivity of the initial SensAheart assay was significantly higher (80.4 vs. 63.8%, <i>p</i> = 0.002) whereas specificity was lower (78.6 vs. 95.4%, <i>p</i> = 0.036). The overall diagnostic accuracy of SensAheart assay was similar to the hs-cTnT (82.7% compared to 76.0%, <i>p</i> = 0.08). <b><i>Conclusions:</i></b> Upon first medical contact, the novel point-of-care rapid SensAheart assay shows a diagnostic performance similar to hs-cTnT. The combination of 2 cardiac biomarkers in the same kit allows for very early detection of myocardial damage. The SensAheart assay is a reliable and practical tool for ruling-in the diagnosis of ACS.

scholarly journals Amino acid PET and MR perfusion imaging in brain tumours

2017 ◽  
Vol 5 (3) ◽  
pp. 209-223 ◽  
Author(s):  
Christian P. Filss ◽  
Francesco Cicone ◽  
Nadim Jon Shah ◽  
Norbert Galldiks ◽  
Karl-Josef Langen
Keyword(s):  
Amino Acid ◽  
Perfusion Imaging ◽  
Brain Tumours ◽  
Mr Perfusion ◽  
Mr Perfusion Imaging ◽  
Amino Acid Pet

scholarly journals Application of contrast enhanced ultrasound in gallbladder lesion: is it helpful to improve the diagnostic capabilities?

2018 ◽  
Vol 20 (4) ◽  
pp. 420 ◽  
Author(s):  
Wen-Tao Kong ◽  
Hi-Yun Shen ◽  
Yu-Dong Qiu ◽  
Hao Han ◽  
Bao-Jie Wen ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Diagnostic Performance ◽  
Color Doppler ◽  
Final Diagnosis ◽  
Wall Thickening ◽  
Contrast Enhanced Ultrasound ◽  
Color Doppler Flow Imaging ◽  
Imaging Characteristics ◽  
Contrast Enhanced ◽  
Significant Difference

The aim of this study is to evaluate if contrast enhanced ultrasound (CEUS) can improve the differential diagnostic performance of gallbladder (GB) lesions.Materials and methods: Forty-nine patients (18 men, 31 women; mean age, 54.8±14.4 years, range age, 22-78 years) with GB lesions (mass-forming and wall-thickened types) were enrolled in this study. All patients underwent conventional ultrasonography (US) and CEUS examination. The imaging characteristics of GB lesions were analyzed to compare the diagnostic performance of US and CEUS. The final diagnosis was obtained by histopathology.Results: There were significant differences between benign and malignant GB lesions with regards to size, shape, vascularity, the integrity and margin of GB wall and time to iso-enhancement on CEUS (p<0.05). However, no significant difference was found concerning the enhancement patterns between the two groups (p>0.05). Logistic regression analysis showed that the boundary between liver and GB wall (p=0.017) and vascularity on color Doppler flow imaging (p=0.013) were two independent predictors of malignancy. The diagnostic accuracy of US could be improved in combination with CEUS (65.3% vs 83.7%). The diagnostic accuracy of the GB wall thickening type was higher than the mass forming type.Conclusion: CEUS could improve the diagnostic performance of GB lesions, especially for wall-thickened type lesions

scholarly journals Bevacizumab Treatment for Symptomatic Radiation Necrosis Diagnosed by Amino Acid PET

2013 ◽  
Vol 43 (3) ◽  
pp. 337-341 ◽  
Author(s):  
M. Furuse ◽  
N. Nonoguchi ◽  
S. Kawabata ◽  
E. Yoritsune ◽  
M. Takahashi ◽  
...  
Keyword(s):  
Amino Acid ◽  
Radiation Necrosis ◽  
Bevacizumab Treatment ◽  
Amino Acid Pet

scholarly journals Improved detection of diffuse glioma infiltration with imaging combinations: a diagnostic accuracy study

2019 ◽  
Vol 22 (3) ◽  
pp. 412-422 ◽  
Author(s):  
Niels Verburg ◽  
Thomas Koopman ◽  
Maqsood M Yaqub ◽  
Otto S Hoekstra ◽  
Adriaan A Lammertsma ◽  
...  
Keyword(s):  
Amino Acid ◽  
Diagnostic Accuracy ◽  
Area Under The Curve ◽  
Local Therapy ◽  
Preoperative Imaging ◽  
Diffuse Glioma ◽  
Characteristic Analysis ◽  
Fet Pet ◽  
Amino Acid Pet ◽  
Better Than

Abstract Background Surgical resection and irradiation of diffuse glioma are guided by standard MRI: T2/fluid attenuated inversion recovery (FLAIR)–weighted MRI for non-enhancing and T1-weighted gadolinium-enhanced (T1G) MRI for enhancing gliomas. Amino acid PET has been suggested as the new standard. Imaging combinations may improve standard MRI and amino acid PET. The aim of the study was to determine the accuracy of imaging combinations to detect glioma infiltration. Methods We included 20 consecutive adults with newly diagnosed non-enhancing glioma (7 diffuse astrocytomas, isocitrate dehydrogenase [IDH] mutant; 1 oligodendroglioma, IDH mutant and 1p/19q codeleted; 1 glioblastoma IDH wildtype) or enhancing glioma (glioblastoma, 9 IDH wildtype and 2 IDH mutant). Standardized preoperative imaging (T1-, T2-, FLAIR-weighted, and T1G MRI, perfusion and diffusion MRI, MR spectroscopy and O-(2-[18F]-fluoroethyl)-L-tyrosine ([18F]FET) PET) was co-localized with multiregion stereotactic biopsies preceding resection. Tumor presence in the biopsies was assessed by 2 neuropathologists. Diagnostic accuracy was determined using receiver operating characteristic analysis. Results A total of 174 biopsies were obtained (63 from 9 non-enhancing and 111 from 11 enhancing gliomas), of which 129 contained tumor (50 from non-enhancing and 79 from enhancing gliomas). In enhancing gliomas, the combination of apparent diffusion coefficient (ADC) with [18F]FET PET (area under the curve [AUC], 95% CI: 0.89, 0.79‒0.99) detected tumor better than T1G MRI (0.56, 0.39‒0.72; P &lt; 0.001) and [18F]FET PET (0.76, 0.66‒0.86; P = 0.001). In non-enhancing gliomas, no imaging combination detected tumor significantly better than standard MRI. FLAIR-weighted MRI had an AUC of 0.81 (0.65–0.98) compared with 0.69 (0.56–0.81; P = 0.019) for [18F]FET PET. Conclusion Combining ADC and [18F]FET PET detects glioma infiltration better than standard MRI and [18F]FET PET in enhancing gliomas, potentially enabling better guidance of local therapy.

scholarly journals Erratum to: Amino acid PET and MR perfusion imaging in brain tumours

2017 ◽  
Vol 5 (4) ◽  
pp. 401-401
Author(s):  
Christian P. Filss ◽  
Francesco Cicone ◽  
Nadim Jon Shah ◽  
Norbert Galldiks ◽  
Karl-Josef Langen
Keyword(s):  
Amino Acid ◽  
Perfusion Imaging ◽  
Brain Tumours ◽  
Mr Perfusion ◽  
Mr Perfusion Imaging ◽  
Amino Acid Pet

scholarly journals Feasibility and diagnostic reliability of quantitative flow ratio in the assessment of non-culprit lesions in acute coronary syndrome

2021 ◽  
Author(s):  
Aslihan Erbay ◽  
Lisa Penzel ◽  
Youssef S. Abdelwahed ◽  
Jens Klotsche ◽  
Anne-Sophie Schatz ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Diagnostic Performance ◽  
Primary Pci ◽  
Flow Ratio ◽  
Diagnostic Reliability ◽  
Index Procedure ◽  
Coronary Syndromes ◽  
Quantitative Flow Ratio ◽  
Quantitative Flow ◽  
Good Agreement

AbstractSeveral studies have demonstrated the feasibility and safety of hemodynamic assessment of non-culprit coronary arteries in setting of acute coronary syndromes (ACS) using fractional flow reserve (FFR) measurements. Quantitative flow ratio (QFR), recently introduced as angiography-based fast FFR computation, has been validated with good agreement and diagnostic performance with FFR in chronic coronary syndromes. The aim of this study was to assess the feasibility and diagnostic reliability of QFR assessment during primary PCI. A total of 321 patients with ACS and multivessel disease, who underwent primary PCI and were planned for staged PCI of at least one non-culprit lesion were enrolled in the analysis. Within this patient cohort, serial post-hoc QFR analyses of 513 non-culprit vessels were performed. The median time interval between primary and staged PCI was 49 [42–58] days. QFR in non-culprit coronary arteries did not change between acute and staged measurements (0.86 vs 0.87, p = 0.114), with strong correlation (r = 0.94, p ≤ 0.001) and good agreement (mean difference -0.008, 95%CI -0.013–0.003) between measurements. Importantly, QFR as assessed at index procedure had sensitivity of 95.02%, specificity of 93.59% and diagnostic accuracy of 94.15% in prediction of QFR ≤ 0.80 at the time of staged PCI. The present study for the first time confirmed the feasibility and diagnostic accuracy of non-culprit coronary artery QFR during index procedure for ACS. These results support QFR as valuable tool in patients with ACS to detect further hemodynamic relevant lesions with excellent diagnostic performance and therefore to guide further revascularisation therapy.

The Added Value of Inflow-Based Vascular-Space-Occupancy and Diffusion-Weighted Imaging in Preoperative Grading of Gliomas

2021 ◽  
pp. 1-8
Author(s):  
Haimei Cao ◽  
Xiang Xiao ◽  
Jun Hua ◽  
Guanglong Huang ◽  
Wenle He ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Roc Curve ◽  
Diffusion Weighted Imaging ◽  
Low Grade ◽  
High Grade ◽  
Mr Images ◽  
Vascular Space ◽  
Diffusion Weighted ◽  
High Grade Gliomas ◽  
And Diffusion

Objectives: The present study aimed to study whether combined inflow-based vascular-space-occupancy (iVASO) MR imaging (MRI) and diffusion-weighted imaging (DWI) improve the diagnostic accuracy in the preoperative grading of gliomas. Methods: Fifty-one patients with histopathologically confirmed diffuse gliomas underwent preoperative structural MRI, iVASO, and DWI. We performed 2 qualitative consensus reviews: (1) structural MR images alone and (2) structural MR images with iVASO and DWI. Relative arteriolar cerebral blood volume (rCBVa) and minimum apparent diffusion coefficient (mADC) were compared between low-grade and high-grade gliomas. Receiver operating characteristic (ROC) curve analysis was performed to compare the tumor grading efficiency of rCBVa, mADC, and the combination of the two parameters. Results: Two observers diagnosed accurate tumor grade in 40 of 51 (78.4%) patients in the first review and in 46 of 51 (90.2%) in the second review. Both rCBVa and mADC showed significant differences between low-grade and high-grade gliomas. ROC analysis gave a threshold value of 1.52 for rCBVa and 0.85 × 10−3 mm2/s for mADC to provide a sensitivity and specificity of 88.0 and 81.2% and 100.0 and 68.7%, respectively. The area under the ROC curve (AUC) was 0.87 and 0.85 for rCBVa and mADC, respectively. The combination of rCBVa and mADC values increased the AUC to 0.92. Conclusion: The combined application of iVASO and DWI may improve the diagnostic accuracy of glioma grading.

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