SummaryF‐18 fluorocholine [fluoromethyl‐dimethyl‐2‐hydroxyethyl‐ammonium (FCH)] is a choline analogue that shows great structural similarity to natural choline. The pathophysiological basis for the use of choline and its derivates for prostate cancer (PC) imaging are the elevation of choline levels and the up‐regulation of choline kinase activity in malignant cells. In order to allow rapid tumour growth, malignant cells are able to trap choline to produce phosphatidylcholine, part of the cellular membrane. As shown in recent studies, F‐18 choline PET and PET/CT might be a valuable tool in detecting the primary tumour in case of elevated prostate‐specific antigen (PSA) serum levels. However, data are not consistent, and further research is necessary before general recommendations concerning F‐18 choline PET and PET/CT can be given in this setting. Furthermore, some studies investigated the accuracy of F‐18 choline PET and PET/CT in detecting lymph node or bone metastases and local recurrences in case of PSA relapse in patients with a history of PC.
Imaging Decisions MRIVolume 13, Issue 1 p. 11-17 Imaging in COPD E. J. R. Van Beek, E. J. R. Van Beek Division of Physiologic Imaging, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA, USASearch for more papers by this authorE. A. Hoffman, E. A. Hoffman Division of Physiologic Imaging, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA, USASearch for more papers by this author E. J. R. Van Beek, E. J. R. Van Beek Division of Physiologic Imaging, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA, USASearch for more papers by this authorE. A. Hoffman, E. A. Hoffman Division of Physiologic Imaging, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA, USASearch for more papers by this author First published: 27 September 2009 https://doi.org/10.1111/j.1617-0830.2009.01130.xCitations: 5 Edwin JR van Beek, M.D. Ph.D. F.R.C.R.Department of Radiology, Carver College of Medicine, University of Iowa, C-751 GH, 200 Hawkins Drive, Iowa City, IA 52242-1077, USATel: 319 384 6133; Fax: 319 356 1503; E-mail: edwin-vanbeek@uiowa.edu Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume13, Issue1Spring 2009Pages 11-17 RelatedInformation
SummaryImaging is crucial for evaluating the presence and extent of prostate cancer. This review illustrates the role of imaging tools including ultrasound, computed tomography, magnetic resonance imaging, sentinel lymph adenectomy, positron emissions tomography and ohers for optimizing diagnosis and therapeutic concept in prostate cancer patients.
Summary Traditionally, myocardial perfusion imaging by CT has been hampered by limited detector size and stability of Hounsfield Units in moving cardiac acquisition modes. In the present article, we describe the technical principles of a novel, dynamic heart shuttle scan acquisition using a second generation dual source CT system (SOMATOM Definition Flash, Siemens Healthcare, Forchheim, Germany). With simultaneous injection of iodinated contrast agent, this protocol allows for sequential assessment of myocardial enhancement with reasonable radiation exposure of less than 10 mSv. We also present the case of a 69‐year‐old male patient who underwent dynamic CT‐based myocardial perfusion imaging to determine the hemodynamic relevance of a stenosis in the left anterior descending coronary artery.
SummaryIn prostate cancer, bone metastasis is related to a poor prognosis and is one of the major causes of morbidity and mortality. Detection of metastatic bone disease is particularly important in prostate cancer patients with high probability for distant metastases before embarking on radical prostatectomy or radiation therapy. The choice of imaging modalities that best depict the metastatic bony lesions may vary depending on different patterns of bone metastases. Bone scintigraphy has been used routinely in the evaluation of prostate cancer patients in the last decades. However, it suffers from adequate specificity. Single photon emission tomography (SPECT) increases the sensitivity and specificity of planar bone scanning especially for the evaluation of the spine. Recently, positron emission tomography (PET) using F‐18 Fluoride shows promising results in the detection of bone metastases especially in cancers with prominent osteoblasic pattern of bone metastases such as prostate cancer. This article reviews the value of conventional planar bone scanning, SPECT, SPECT/CT as well as F‐18 Fluoride PET/CT in the assessment of bone metastases in prostate cancer patients.
SummaryTime‐adaptive sensitivity encoding (TSENSE) and generalized autocalibrating partially parallel acquisition (GRAPPA) were applied to a gradient‐echo sequence used for first‐pass myocardial perfusion imaging of 12 patients with coronary artery disease. The two parallel imaging methods were compared in terms of signal‐to‐noise ratio (SNR), contrast‐to‐noise ratio (CNR) and image artefacts. Image acquisition was started during the administration of a Gd‐contrast bolus (0.1 mmoL/kg) followed by a 20‐mL saline flush (3 mL/s), and the next perfusion was started at least 15 min thereafter using an identical bolus. The order of perfusion sequences was inverted in every other patient. Both acquisitions had an acceleration rate of 2, and were performed during breath‐holding. The SNR, CNR and image quality of the GRAPPA images were significantly better than were those of the TSENSE images. An exception was the lower CNR of GRAPPA when applied after the second bolus. Differences between subjects were larger with GRAPPA perfusion imaging than with TSENSE. The SNR and CNR also varied relatively much between the GRAPPA images, indicating that the diagnostic value of TSENSE may be superior after all.
Summary Mammography is the primary imaging modality for the early detection of breast cancer. Because of the low predictive value of mammography, a large majority of patient referred for biopsy have benign disease. The question is whether magnetic resonance imaging (MRI) is a diagnostic alternative to biopsy for women with inconclusive findings at mammography or mammographic (Breast Imaging Reporting And Data System (BIRADS) 3 lesions. In this article the breast MRI and indications will be described. An overview will be given of MRI as a problem‐solving modality in mammographic BIRADS 3 lesions and inconclusive mammographic findings with and without microcalcifications. The negative predictive value of breast MRI must be sufficiently high to definitively indicate a lack of need for biopsy and thus to be an effective addition to the work‐up of mammographic BIRADS 3 lesions or inconclusive findings on mammography. Therefore, breast MRI should only be used for cases with proven diagnostic value.
Imaging Decisions MRIVolume 13, Issue 3-4 p. 104-104 Breast Imaging, Overview and New Developments R. Pijnappel, R. Pijnappel Department of Radiology Martini Hospital Groningen The NetherlandsE-mail: r.pijnappel@mzh.nlSearch for more papers by this author R. Pijnappel, R. Pijnappel Department of Radiology Martini Hospital Groningen The NetherlandsE-mail: r.pijnappel@mzh.nlSearch for more papers by this author First published: 31 March 2010 https://doi.org/10.1111/j.1617-0830.2010.01142.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume13, Issue3-4Fall/Winter 2009Pages 104-104 RelatedInformation
Imaging Decisions MRIVolume 13, Issue 3-4 p. 67-67 Imaging Decisions – a successful project Klaus Mickus, Klaus Mickus Journal Publishing ManagerWiley-BlackwellSearch for more papers by this author Klaus Mickus, Klaus Mickus Journal Publishing ManagerWiley-BlackwellSearch for more papers by this author First published: 31 March 2010 https://doi.org/10.1111/j.1617-0830.2010.01143.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume13, Issue3-4Fall/Winter 2009Pages 67-67 RelatedInformation
SummaryManagement of CF patients currently relies on clinical status, lung function tests, sputum cultures and scoring systems based on chest X‐ray (CXR). None of these tests give adequate information about regional lung function or are sensitive enough to demonstrate subtle changes that may aid in assessing early lung disease status, planning therapy or evaluating response to treatment. There is increasing evidence from recent studies with CT and MRI that current routine measures of lung physiology, (spirometry) and structure (CXR), may not accurately reflect disease progression nor identify early stages of lung disease, often remaining within a normal range even when significant and irreversible pulmonary damage has already occurred. Thus accurate, non‐invasive, regional methods of diagnosis and follow up of CF patients based upon imaging endpoints are highly desirable. In this paper, state of the art methods of imaging signs of lung disease in the CF lung are reviewed with discussions on the technical advances in CT, proton and hyperpolarised gas MRI with example images from groups active in the area of CF lung imaging.
SummarySingle voxel magnetic resonance spectroscopy (MRS) has been the standard in human breast tumour studies published to date. This method is hampered by the impossibility to study tissue heterogeneity or compare the metabolite signals in breast lesion directly to those in unaffected tissue. Multivoxel MRS studies, frequently referred to as spectroscopic imaging, while potentially allowing for truly quantitative tissue characterization, have up to now also been far from quantitative with, for example, the signal‐to‐noise ratio of the choline (Cho) signal serving as a measure of tumour activity. Demonstrated in this study is that in a standard clinical setting with a regular 1.5 T MR scanner, it is possible to perform quantitative multivoxel MRS. Using a pre‐measurement to map the distributions of water and fat, and literature values for the T1 and T2 relaxation times of Cho and water in fibroglandular breast tissue and tumours, one can determine the concentrations of Cho in different tumour compartments and surrounding tissues in two brief multivoxel MRS measurements. Quantitative diagnostic and follow‐up studies of focal breast pathology are now possible.
SummaryDuring the past decade, imaging has become of paramount importance in the diagnosis of patients with interstitial lung disorders. In addition, the quantification of radiographic features at the time of diagnosis gives important prognostic information and changes in these features over time may prove to be useful outcome variables in the study of new treatments and monitoring of patients’ response to therapy. In this chapter, we review the classification of interstitial lung diseases focusing on the role of high‐resolution computed tomography (HRCT), particularly as it pertains to the need for obtaining a surgical lung biopsy. We also discuss the role of baseline and longitudinal semi‐quantitative and quantitative measurement of HRCT features in assessment of patients with idiopathic pulmonary fibrosis (IPF).
SummaryThere are many different imaging studies that can be used to evaluate breast lesions. This article will provide a brief introduction to each of the different examination modalities, including mammography, ultrasound and magnetic resonance imaging as well as image‐guided invasive procedures. General guidelines for recommended use of each modality are suggested.
SummaryA unique multi‐center consortium of research centers, the severe asthma research program (SARP), is working to define asthma phenotypes, with a particular focus on severe asthma due to the higher prevalence of exacerbations and hospital visits in these patients. The consortium includes comprehensive studies of physiology, genotype, and inflammatory biomakers in addition to a lung imaging substudy in nearly 400 subjects. The imaging substudy is comparing quantitative computed tomography (CT) measures of airway morphology and parenchymal density to asthma severity and other makers of asthma. Results show increased wall thickness and increased regional air trapping in severe versus non‐severe asthma. Image‐guided bronchoscopic assessment using either CT or hyperpolarized gas magnetic resonance imaging (MRI) shows that highly diseased airways have increased wall thickness on histology and greater inflammatory cell numbers. Large scale imaging studies such as SARP may provide a means to better understand and guide effective treatment of severe asthma.
Imaging Decisions MRIVolume 13, Issue 1 p. 1-1 Pulmonary Imaging E. J. R. Van Beek, E. J. R. Van Beek Professor of Radiology and Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USAE-mail: edwin-vanbeek@uiowa.eduSearch for more papers by this author E. J. R. Van Beek, E. J. R. Van Beek Professor of Radiology and Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USAE-mail: edwin-vanbeek@uiowa.eduSearch for more papers by this author First published: 27 September 2009 https://doi.org/10.1111/j.1617-0830.2009.01129.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume13, Issue1Spring 2009Pages 1-1 RelatedInformation
SummaryMagnetic Resonance Imaging (MRI) of the chest and especially the lung is more and more accepted as a valuable additional imaging modality for several pulmonary diseases. Magnetic Resonance Imaging allows for combined morphological and functional imaging and therefore elucidates perfectly the effect of parenchymal changes and destruction onto pulmonary perfusion and ventilation. This overview presents the current status for the application of pulmonary MRI in chronic obstructive pulmonary disease as well as infectious and neoplastic diseases.
SummaryFirst‐pass perfusion imaging with MRI under pharmacologically induced stress for the detection of myocardial ischemia has gained a lot of interest over the past years. With adenosine as the main pharmacological ‘stressor’. Issues regarding the best contrast dose and injection speed have become clear. Several perfusion sequences have been studied over the past. Even some large multi‐centre trail results have been published. Some issues are still extensively research, like interpretation strategies and patient population in regard to protocols. This review highlights the technique of adenosine perfusion MRI and other perfusion techniques. The short history and current important literature are reviewed. Furthermore building blocks for different stress perfusion examinations are discussed.
SummaryMyocardial perfusion imaging (MPI) using single photon emission computed tomography (SPECT) or positron emission tomography (PET) techniques is a well‐established diagnostic tool in clinical medicine providing non‐invasively information about cardiac perfusion, function and prognosis in patients with coronary artery disease. Gated SPECT MPI has been used in clinical routine for years allowing the characterization of localization, extent and severity of perfusion abnormalities both in women and men. Recently, clinical studies employing nuclear techniques (e.g. BASKET or COURAGE) have underlined its diagnostic accuracy, prognostic validity and its importance for the clinical decision making. The extent of stress‐induced ischaemia is of clinical relevance to guide decision making in the management of the cardiac patient. Improvements in nuclear imaging equipment, software for image analysis and stress techniques will accelerate the procedure and increase its diagnostic accuracy while reducing radiation exposure.
Summary Magnetic resonance imaging (MRI) of the breast has become a well-established method for detection of invasive breast carcinoma. However, the role and use of breast MRI for ductal carcinoma in situ (DCIS) has remained controversial. The purpose of this study was to assess the diagnostic performance of breast MRI for detection and characterization of pure DCIS based on the currently published reports. A systematic review was performed in which studies on breast MRI for diagnosis of patients with pure DCIS were selected. A total of 26 articles were finally included, a total of 1051 patients with 1059 lesions. Sensitivity for diagnosis of pure DCIS ranged from 58% to 100%, with an overall of 84%. Sensitivity was highest for high-grade DCIS (95%). Overall specificity was 74%. The majority of DCIS lesions were characterized as non-mass-like enhancement (75%) with a segmental distribution of enhancement (50%). Suspicious kinetic curves were found in 49% of the DCIS cases. A few studies reported on size assessment. This review shows that MRI has a moderate sensitivity for detection of DCIS in general, and a good sensitivity for high-grade DCIS. The morphologic and kinetic appearance of DCIS can be very variable. Although mammography is the current standard for detection of DCIS, MRI could help improve the ability to diagnose DCIS, especially in high-grade DCIS.
SummaryF‐18 FDG positron emission tomography (PET) is able to diagnose viable lymphoma tissue due to its elevated glucose metabolism, independent of the size of the lesions. For staging purposes, the value of FDG PET in Hodgkin’s (HL) and high‐grade non‐Hodgkin lymphoma (NHL) lies predominantly in a change of tumour stage with the consequence of a modification of therapeutic regimen and a more exact definition of radiotherapy (RTX) planning volume. In indolent lymphoma, a pre‐therapeutic scan is mandatory for further therapy monitoring due to variable FDG‐uptake. In restaging HL and NHL, discrimination between viable residual lymphoma and necrosis in case of a residual bulk is possible with FDG PET, which is limited by conventional methods. PET/CT combines the advantages of PET and CT and performs better than each method alone by further improving the accuracy of staging and response assessment over that of CT alone. There are a lower proportion of equivocal or benign findings because PET‐CT specifies the nature of uptake. Some studies have demonstrated the possibility of therapy monitoring, but further prospective studies have to be performed before therapy may be avoided or modified according to the results of the PET/CT examination.
