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  • Online Resource  (40)
  • SAGE Publications  (40)
  • 1
    Online Resource
    Online Resource
    Comparison of intrahepatic progression patterns of hepatocellular carcinoma and colorectal liver metastases following CT-guided high dose-rate brachytherapy
    SAGE Publications ; 2021
    In:  Therapeutic Advances in Medical Oncology Vol. 13 ( 2021-01), p. 175883592110423-
    Details
    In: Therapeutic Advances in Medical Oncology, SAGE Publications, Vol. 13 ( 2021-01), p. 175883592110423-
    Abstract: Given the metachronous and multifocal occurrence of hepatocellular carcinoma (HCC) and colorectal cancer metastases in the liver (CRLM), this study aimed to compare intrahepatic progression patterns after computed tomography (CT)-guided high dose-rate brachytherapy. Patients and methods: This retrospective analysis included 164 patients (114 HCC, 50 CRLM) treated with brachytherapy between January 2016 and January 2018. Patients received multiparametric magnetic resonance imaging (MRI) before, and about 8 weeks after brachytherapy, then every 3 months for the first, and every 6 months for the following years, until progression or death. MRI scans were assessed for local or distant intrahepatic tumor progression according to RECIST 1.1 and electronic medical records were reviewed prior to therapy. The primary endpoint was progression-free survival (PFS). Specifically, local and distant intra-hepatic PFS were assessed to determine differences between the intrahepatic progression patterns of HCC and CRLM. Secondary endpoints included the identification of predictors of PFS, time to progression (TTP), and overall survival (OS). Statistics included Kaplan–Meier analysis and univariate and multivariate Cox regression modeling. Results: PFS was longer in HCC [11.30 (1.33–35.37) months] than in CRLM patients [8.03 (0.73–19.80) months, p = 0.048] , respectively. Specifically, local recurrence occurred later in HCC [PFS: 36.83 (1.33–40.27) months] than CRLM patients [PFS: 12.43 (0.73–21.90) months, p = 0.001] . In contrast, distant intrahepatic progression occurred earlier in HCC [PFS: 13.50 (1.33–27.80) months] than in CRLM patients [PFS: 19.80 (1.43–19.80) months, p = 0.456] but without statistical significance. Multivariate Cox regression confirmed tumor type and patient age as independent predictors for PFS. Conclusion: Brachytherapy proved to achieve better local tumor control and overall PFS in patients with unresectable HCC as compared to those with CRLM. However, distant progression preceded local recurrence in HCC. As a result, these findings may help design disease-specific surveillance strategies and personalized treatment planning that highlights the strengths of brachytherapy. They may also help elucidate the potential benefits of combinations with other loco-regional or systemic therapies.
    Type of Medium: Online Resource
    ISSN: 1758-8359 , 1758-8359
    URL: Article
    DOI: 10.1177/17588359211042304
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2503443-1
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  • 2
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    The value of ADC, T2 signal intensity, and a combination of both parameters to assess Gleason score and primary Gleason grades in patients with known prostate cancer
    SAGE Publications ; 2016
    In:  Acta Radiologica Vol. 57, No. 1 ( 2016-01), p. 107-114
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 57, No. 1 ( 2016-01), p. 107-114
    Abstract: The ability to non-invasively analyze tumor aggressiveness is an important predictor for individual treatment stratification and patient outcome in prostate cancer (PCA). Purpose To evaluate: (i) whether apparent diffusion coefficient (ADC), the T2 signal intensity (SI), and a combination of both parameters allow for an improved discrimination of Gleason Score (GS) ≥7 (intermediate and high risk) and GS 〈 7 (low risk) in PCA; and (ii) whether ADC may distinguish between 3 + 4 and 4 + 3 PCA (primary Gleason grades [pGG]). Material and Methods Prostatectomy specimens of 66 patients (mean age, 63 ± 5.6 years; 104 PCA foci) with a preceding multiparametric 1.5 T endorectal coil magnetic resonance imaging (MRI) were included. ADC ( b values = 0, 100, 400, 800 s/mm 2 ), standardized T2 (T2s), and the ADC/T2s ratio were tested for correlation with GS applying multivariate analysis. ADC cutoff values were calculated for prediction of GS and pGG, and logarithm of the odds (LOGIT) was used to express the probability for GS and pGG. Diagnostic accuracy was assessed by ROC analysis. Results We found an almost linear negative relationship of ADC for GS ≥7 ( P = 0.002). The effect of ADC for GS ≥7 (adjusted odds ratio = 0.995) was almost identical for peripheral and transition zone PCA ( P = 0.013 and P  〈  0.001, respectively). ADC showed an AUC of 78.9% for discrimination between GS 〈 7 and GS ≥7. An ADC cutoff of 〈 1.005 × 10 −3  mm 2 /s indicated a GS ≥7 (90.5% sensitivity, 62.5% specificity). Within the group of GS = 7 PCA, an ADC  〉  0.762 × 10 −3  mm 2 /s indicated a pGG of 3 (AUC = 69.6%). Conclusion T2s and the ADC/T2s ratio do not provide additional information regarding prediction of GS. ADC values have a good discriminatory power to distinguish tumors with GS ≥7 from GS 〈 7 and to predict pGG in GS = 7 PCA.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185114561915
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2024579-8
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  • 3
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    A 3D quantitative imaging biomarker in pre-treatment MRI predicts overall survival after stereotactic radiation therapy of patients with a singular brain metastasis
    SAGE Publications ; 2019
    In:  Acta Radiologica Vol. 60, No. 11 ( 2019-11), p. 1496-1503
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 60, No. 11 ( 2019-11), p. 1496-1503
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185119831692
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2024579-8
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  • 4
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    Can optimized model-based iterative reconstruction improve the contrast of liver lesions in CT?
    SAGE Publications ; 2023
    In:  Acta Radiologica Vol. 64, No. 1 ( 2023-01), p. 42-50
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 64, No. 1 ( 2023-01), p. 42-50
    Abstract: Computed tomography is a standard imaging procedure for the detection of liver lesions, such as metastases, which can often be small and poorly contrasted, and therefore hard to detect. Advances in image reconstruction have shown promise in reducing image noise and improving low-contrast detectability. Purpose To examine a novel, specialized, model-based iterative reconstruction (MBIR) technique for improved low-contrast liver lesion detection. Material and Methods Patient images with reported poorly contrasted focal liver lesions were retrospectively reconstructed with the low-contrast attenuating algorithm (FIRST-LCD) from primary raw data. Liver-to-lesion contrast, signal-to-noise, and contrast-to-noise ratios for background and liver noise for each lesion were compared for all three FIRST-LCD presets with the established hybrid iterative reconstruction method (AIDR-3D). An additional visual conspicuity score was given by two experienced radiologists for each lesion. Results A total of 82 lesions in 57 examinations were included in the analysis. All three FIRST-LCD algorithms provided statistically significant increases in liver-to-lesion contrast, with FIRST MILD showing the largest increase (40.47 HU in AIDR-3D; 45.84 HU in FIRST MILD ; P  〈  0.001). Substantial improvement was shown in contrast-to-noise metrics. Visual analysis of the lesions shows decreased lesion visibility with all FIRST methods in comparison to AIDR-3D, with FIRST STR showing the closest results ( P  〈  0.001). Conclusion Objective image metrics show promise for MBIR methods in improving the detectability of low-contrast liver lesions; however, subjective image quality may be perceived as inferior. Further improvements are necessary to enhance image quality and lesion detection.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/02841851211070119
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2024579-8
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  • 5
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    Monitoring of Liver Cell Transplantation in a Preclinical Swine Model Using Magnetic Resonance Imaging
    SAGE Publications ; 2010
    In:  Cell Medicine Vol. 1, No. 3 ( 2010-11), p. 123-136
    Details
    In: Cell Medicine, SAGE Publications, Vol. 1, No. 3 ( 2010-11), p. 123-136
    Abstract: Liver cell transplantation (LCT) is a promising treatment approach for certain liver diseases, but clinical implementation requires methods for noninvasive follow-up. Labeling with superparamagnetic iron oxide particles can enable the detection of cells with magnetic resonance imaging (MRI). We investigated the feasibility of monitoring transplanted liver cells by MRI in a preclinical swine model and used this approach to evaluate different routes for cell application. Liver cells were isolated from landrace piglets and labeled with micron-sized iron oxide particles (MPIO) in adhesion. Labeled cells ( n = 10), native cells ( n = 3), or pure particles ( n = 4) were transplanted to minipigs via intraportal infusion into the liver, direct injection into the splenic parenchyma, or intra-arterial infusion to the spleen. Recipients were investigated by repeated 3.0 Tesla MRI and computed tomography angiography up to 8 weeks after transplantation. Labeling with MPIO, which are known to have a strong effect on the magnetic field, enabled noninvasive detection of cell aggregates by MRI. Following intraportal application, which is commonly applied for clinical LCT, MRI was able to visualize the microembolization of transplanted cells in the liver that were not detected by conventional imaging modalities. Cells directly injected into the spleen were retained, whereas cell infusions intra-arterially into the spleen led to translocation and engraftment of transplanted cells in the liver, with significantly fewer microembolisms compared to intraportal application. These findings demonstrate that MRI can be a valuable tool for noninvasive elucidation of cellular processes of LCT and—if clinically applicable MPIO are available—for monitoring of LCT under clinical conditions. Moreover, the results clarify mechanisms relevant for clinical practice of LCT, suggesting that the intra-arterial route to the spleen deserves further evaluation.
    Type of Medium: Online Resource
    ISSN: 2155-1790 , 2155-1790
    URL: Article
    DOI: 10.3727/215517910X551053
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2010
    detail.hit.zdb_id: 2634804-4
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  • 6
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    Apparent Migration of Implantable Port Devices: Normal Variations in Consideration of BMI
    SAGE Publications ; 2016
    In:  The Journal of Vascular Access Vol. 17, No. 2 ( 2016-03), p. 155-161
    Details
    In: The Journal of Vascular Access, SAGE Publications, Vol. 17, No. 2 ( 2016-03), p. 155-161
    Abstract: To evaluate the extent of normal variation in implantable port devices between supine fluoroscopy and upright chest x-ray in relation to body mass index (BMI) based on three different measurement methods. Methods Retrospectively, 80 patients with implanted central venous access port systems from 2012-01-01 until 2013-12-31 were analyzed. Three parameters (two quantitative and one semi-quantitative) were determined to assess port positions: projection of port capsule to anterior ribs (PCP) and intercostal spaces, ratio of extra- and intravascular catheter portions (EX/IV), normalized distance of catheter tip to carina (nCTCD). Changes were analyzed for males and females and normal-weight and overweight patients using analysis of variance with Bonferroni-corrected pairwise comparison. Results PCP revealed significantly greater changes in chest x-rays in overweight women than in the other groups (p 〈 0.001, F-test). EX/IV showed a significantly higher increase in overweight women than normal-weight women and men and overweight men (p 〈 0.001). nCTCD showed a significantly greater increase in overweight women than overweight men (p = 0.0130). There were no significant differences between the other groups. Inter- and intra-observer reproducibility was high (Cronbach alpha of 0.923-1.0) and best for EX/IV. Conclusions Central venous port systems show wide normal variations in the projection of catheter tip and port capsule. In overweight women apparent catheter migration is significantly greater compared with normal-weight women and with men. The measurement of EX/IV and PCP are straightforward methods, quick to perform, and show higher reproducibility than measurement of catheter tip-to-carina distance.
    Type of Medium: Online Resource
    ISSN: 1129-7298 , 1724-6032
    URL: Article
    DOI: 10.5301/jva.5000502
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2079292-X
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  • 7
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    Author's Reply
    SAGE Publications ; 2010
    In:  The Journal of Vascular Access Vol. 11, No. 2 ( 2010-04), p. 178-178
    Details
    In: The Journal of Vascular Access, SAGE Publications, Vol. 11, No. 2 ( 2010-04), p. 178-178
    Type of Medium: Online Resource
    ISSN: 1129-7298 , 1724-6032
    URL: Article
    DOI: 10.1177/112972981001100222
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2010
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  • 8
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    Hepatopulmonary shunting after surgical, interventional and systemic therapy in patients with liver malignancies scheduled for radioembolization
    SAGE Publications ; 2016
    In:  Acta Radiologica Vol. 57, No. 8 ( 2016-08), p. 908-913
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 57, No. 8 ( 2016-08), p. 908-913
    Abstract: Hepatopulmonary shunts (HPS) lead to radiation exposure of the lungs in patients undergoing radioembolization (RE) of malignant liver tumors. Purpose To retrospectively analyze how HPS is affected by prior systemic or local therapy of the liver. Material and Methods The percentage HPS was calculated from SPECT/CT scans obtained after technetium-99 m macroaggregated albumin administration into hepatic arteries in 316 patients evaluated for RE. Results Patients with partial liver resection ( n = 80) did not differ in HPS from the remaining patient population ( n = 236) (HPS (median [range]) = 10.2 [2.1–48.3] resection % vs. 8.9 [2.3–32.9] no resection %; P = 0.527). In patients undergoing sequential RE, HPS was significantly higher in the liver lobe treated second ( n = 10; HPS = 6.4 [2.1–10.2] firstlobe/session % vs. 12.0 [2.0–24.6] second lobe/session %; P = 0.019). (Chemo-)embolization ( n = 19; HPS = 11.0 [2.8–48.3]%) or transcutaneous ablation ( n = 63; HPS = 8.8 [3.0–32.9] %) had no effect on HPS compared to patients without prior interventions (no (chemo-)embolization: n = 297; HPS = 9.3 [2.1–47.3]%; P = 0.489; no ablation: n = 253; HPS = 9.5 [2.1–48.3] %; P = 0.382). Pretreatment with sorafenib (HPS = 9.5 [2.3–35.9] yes % vs. 10.2 [2.8–42.0] no %; P = 0.777) orbevacizumab (HPS = 10.7 [2.1–30.6] yes % vs. 9.0 [3.9–23.3] no %; P = 0.870) had no effect on HPS. Conclusion Sequential RE results in an increase in the HPS in the contralateral liver lobe at the time of the second RE session. Other investigated therapy do not affect HPS.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185115605680
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2024579-8
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  • 9
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    Influence of fractional anisotropy thresholds on diffusion tensor imaging tractography of the periprostatic neurovascular bundle and selected pelvic tissues: do visualized tracts really represent nerves?
    SAGE Publications ; 2017
    In:  Acta Radiologica Vol. 58, No. 4 ( 2017-04), p. 472-480
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 58, No. 4 ( 2017-04), p. 472-480
    Abstract: Diffusion tensor imaging (DTI) tractography has recently been shown to successfully visualize periprostatic tracts allegedly representing the neurovascular bundle. Purpose To examine the impact of different fractional anisotropy (FA) thresholds on the results of DTI tractography in the male pelvis as well as to evaluate the resulting specificity for nerve tracts. Material and Methods Ten healthy male volunteers were examined at 3 Tesla. DTI tractography was performed based on seed points placed circularly around the prostate, in the rectoprostatic angle, the peripheral zone of the prostate, the sciatic nerve, and in addition the urinary bladder using FA thresholds of 0.20, 0.05, and 0.01. DTI tract number and DTI tract length measured with different FA thresholds were compared. ANOVA with repeated measures was used for statistics. Results DTI tract number and tract length were significantly dependent on FA thresholds. While a FA threshold of 0.20 visualized the typical distribution of DTI tracts in the sciatic nerve, a FA threshold of ≤0.05 was necessary to yield results visually mimicking the distribution of nerve tracts in the NVB. However, with such low FA thresholds even in the filled urinary bladder DTI tracts could be visualized. With FA thresholds of 0.20, the number and length of periprostatic DTI tracts did not differ from those measured within the prostate. Conclusion DTI tractography can be used to visualize DTI tracts periprostatically. However, one may doubt that these DTI tracts represent nerve tracts and that the periprostatic neurovascular bundle can be evaluated in a meaningful way with the current methods available.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185116651004
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
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  • 10
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    DCE-MR imaging of orbital lesions: diagnostic performance of the tumor flow residence time τ calculated by a multi-compartmental pharmacokinetic tumor model based on individual factors
    SAGE Publications ; 2019
    In:  Acta Radiologica Vol. 60, No. 5 ( 2019-05), p. 643-652
    Details
    In: Acta Radiologica, SAGE Publications, Vol. 60, No. 5 ( 2019-05), p. 643-652
    Abstract: Differentiating benign from malignant orbital lesions by imaging and clinical presentation can be challenging. Purpose To differentiate benign from malignant orbital masses using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) based on tumor flow residence time τ calculated with the aid of a pharmacokinetic tumor model. Material and Methods Sixty patients with orbital masses were investigated by 3-T MRI including dynamic sequences. The signal intensity-time curve after i.v. contrast medium administration within lesions was approximated by Gd-concentration profiles on the basis of model calculations where the tumor is embedded in a whole-body kinetic model. One output of the model was tumor flow residence time τ, defined as the ratio of the tumor volume and the tumor blood flow rate. Receiver operating characteristic (ROC) curves were used to analyze the diagnostic performance of τ. The results were compared with those of K trans , k ep , v e , iAUC, and ADC. Results Thirty-one benign and 29 malignant orbital masses were identified (reference standard: histopathology, clinical characteristics). Mean τ was significantly longer for benign masses (94 ± 48 s) than for malignant masses (21 ± 19 s, P  〈  0.001). ROC analysis revealed the highest area under the curve (AUC = 0.94) for τ in orbital masses compared to standard methods. Conclusion Tumor flow residence times τ of benign and malignant orbital masses are valuable in the diagnostic work-up of orbital tumors. Measures of diagnostic accuracy were superior for τ compared to ADC, K trans , v e , and iAUC.
    Type of Medium: Online Resource
    ISSN: 0284-1851 , 1600-0455
    URL: Article
    DOI: 10.1177/0284185118795324
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2024579-8
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