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MRI Guided

Jacques Klein, Arachk de Górski, Daniel Benamran, Jean-Paul Vallee, Thomas De Perrot, Gregory J Wirth, Christophe E Iselin
INTRODUCTION: The study aimed to evaluate 3 different modalities of transrectal ultrasound (TRUS)-guided prostate biopsies (PBs; 2D-, 3D- and targeted 3D-TRUS with fusion to MRI - T3D). Primary end point was the detection rate of prostate cancer (PC). Secondary end point was the detection rate of insignificant PC according to the Epstein criteria. PATIENTS AND METHODS: Inclusion of 284 subsequent patients who underwent 2D-, 3D- or T3D PB from 2011 to 2015. All patients having PB for initial PC detection with a serum prostate-specific antigen value ≤20 ng/ml were included...
October 27, 2016: Urologia Internationalis
Manigandan Subramanyam Thyagarajan, Khalid Sharif
Space occupying liver lesions usually present with abdominal pain or abnormal physical findings, such as a palpable abdominal mass or distention. Liver lesions identified in children include benign and malignant neoplasms, inflammatory masses, cysts and metastatic lesions. Two-thirds of liver lesions in children are malignant. Hepatoblastoma accounts for two-thirds of malignant liver tumors in children. Benign lesions of the liver in children include vascular lesions, hamartomas, adenomas, and focal nodular hyperplasia...
October 25, 2016: Indian Journal of Pediatrics
Dan Nguyen, David Thomas, Minsong Cao, Daniel O'Connor, James Lamb, Ke Sheng
PURPOSE: Magnetic resonance imaging (MRI)-guided Co-60 provides daily and intrafractional MRI soft tissue imaging for improved target and critical organ tracking. To increase delivery efficiency, the system uses three Co-60 sources at 120° apart, allowing up to 600 cGy combined dose rate at isocenter. Despite the potential tripling in output, creating a delivery plan that uses all three sources is considerably unintuitive. Here, the authors computerize the triplet orientation optimization using column generation, an approach that was demonstrated effective in integrated beam orientation and fluence optimization for noncoplanar therapies...
October 2016: Medical Physics
Maxence Borot de Battisti, Baudouin Denis de Senneville, Metha Maenhout, Jan J W Lagendijk, Marco van Vulpen, Gilion Hautvast, Dirk Binnekamp, Marinus A Moerland
PURPOSE: The development of MR-guided high dose rate (HDR) brachytherapy is under investigation due to the excellent tumor and organs at risk visualization of MRI. However, MR-based localization of needles (including catheters or tubes) has inherently a low update rate and the required image interpretation can be hampered by signal voids arising from blood vessels or calcifications limiting the precision of the needle guidance and reconstruction. In this paper, a new needle tracking prototype is investigated using fiber Bragg gratings (FBG)-based sensing: this prototype involves a MR-compatible stylet composed of three optic fibers with nine sets of embedded FBG sensors each...
October 2016: Medical Physics
Enrico Franco, Mike Ristic, Marc Rea, Wladyslaw M W Gedroyc
PURPOSE: Percutaneous ablation under MRI-guidance allows treating otherwise inoperable liver tumors locally using a catheter probe. However, manually placing the probe is an error-prone and time consuming task that requires a considerable amount of training. The aim of this paper was to present a pneumatically actuated robotic instrument that can assist clinicians in MRI-guided percutaneous intervention of the liver and to assess its functionality in a clinical setting. The robot positions a needle-guide inside the MRI scanner bore and assists manual needle insertions outside the bore...
October 2016: Medical Physics
Jonathan M Behar, Simon Claridge, Tom Jackson, Ben Sieniewicz, Bradley Porter, Jessica Webb, Ronak Rajani, Stamatis Kapetanakis, Gerald Carr-White, Christopher A Rinaldi
Cardiac resynchronization therapy (CRT) is an effective pacemaker delivered treatment for selected patients with heart failure with the target of restoring electro-mechanical synchrony. Imaging techniques using echocardiography have as yet failed to find a metric of dyssynchrony to predict CRT response. Current guidelines are thus unchanged in recommending prolonged QRS duration, severe systolic function and refractory heart failure symptoms as criteria for CRT implantation. Evolving strain imaging techniques in 3D echocardiography, cardiac MRI and CT may however, overcome limitations of older methods and yield more powerful CRT response predictors...
October 26, 2016: Expert Review of Cardiovascular Therapy
S Ipsen, O Blanck, N J Lowther, G P Liney, R Rai, F Bode, J Dunst, A Schweikard, P J Keall
Radiosurgery to the pulmonary vein antrum in the left atrium (LA) has recently been proposed for non-invasive treatment of atrial fibrillation (AF). Precise real-time target localization during treatment is necessary due to complex respiratory and cardiac motion and high radiation doses. To determine the 3D position of the LA for motion compensation during radiosurgery, a tracking method based on orthogonal real-time MRI planes was developed for AF treatments with an MRI-guided radiotherapy system. Four healthy volunteers underwent cardiac MRI of the LA...
November 21, 2016: Physics in Medicine and Biology
Rosa M Michel Ortega, Daynna J Wolff, Cynthia A Schandl, Harry A Drabkin
BACKGROUND: Malignancy after transplantation is an uncommon multifactorial occurrence. Immunosuppression to prevent graft rejection is described as a major risk factor in malignancy development in the post-transplant state. Donor-derived malignancy is a rare reported complication. Herein, we review our patient history and discuss diagnostic strategies and the implications of immunosuppression for donor-derived malignancy. CASE PRESENTATION: This is a 69-year-old man with post-renal-transplant urothelial carcinoma determined to be of donor origin...
2016: Journal for Immunotherapy of Cancer
Melvy Sarah Mathew, Aytekin Oto
With the advent of focal therapy as a recognized treatment option for men with prostate cancer, there are a host of emerging interventions that take advantage of MRI for image guidance. Focal therapy affords a middleground option for patients with low- to intermediate-grade prostate cancer by providing a means of keeping their cancer at bay while avoiding the negative consequences of radical therapies. However, the practice of focal treatment is far from straightforward, with some believing focal treatment errs on the side of overtreatment among patients with low-grade cancer; others worry it is undertreatment in potentially significant multifocal disease...
October 25, 2016: Future Oncology
Florent L Besson, Paul Blanc-Durand, Céline Meyer, Gilles Grimon, Emmanuel Durand
Eumycetoma is a chronic tropical fungal disease that infiltrates subcutaneous tissues, mainly in the feet and legs. Standard antifungal drugs are ineffective, and mutilating surgery is common. Morphological imaging is useful for assessing the local extent of the disease before surgery. FDG PET/CT may be of potential interest for the general extent, but PET descriptions remain scarce and mostly relate to the feet. Here, the authors present FDG PET/CT and MRI study of a very rare case of an extensive, biopsy-proven eumycetoma of the right thigh that was performed to guide potential surgery...
October 21, 2016: Clinical Nuclear Medicine
Ming Ma, Fei Yan, Minghua Yao, Zijun Wei, Dongliang Zhou, Heliang Yao, Hairong Zheng, Hangrong Chen, Jianlin Shi
Entirely differing from the common templating-based multistep strategy in fabricating multifunctional hollow mesoporous silica nanoparticles (HMSNs), a facile and template-free synthetic strategy has been established in constructing a unique hollow/mesoporous organosilica nanocapsule concurrently encapsulating both isopentyl acetate (PEA) liquid and superparamagnetic iron oxides inside (denoted as PEA@OSNCs). This novel material exhibits ultrasmall and uniform particle size (~82 nm), high surface area (~534 m2 g-1) and excellent colloidal stability in aqueous solution...
October 24, 2016: ACS Applied Materials & Interfaces
Tarun Rustagi, Ferga C Gleeson, Suresh T Chari, Barham K Abu Dayyeh, Michael B Farnell, Prasad G Iyer, Michael L Kendrick, Randall K Pearson, Bret T Petersen, Elizabeth Rajan, Mark D Topazian, Mark J Truty, Santhi S Vege, Kenneth K Wang, Michael J Levy
BACKGROUND AND AIMS: Malignant vascular invasion usually results from gross direct infiltration from a primary tumor, and impacts cancer staging, prognosis, and therapy. However, patients may also develop a remote malignant thrombi (RMT), defined as a malignant intravascular thrombus located remote and noncontiguous to the primary tumor. Our aim was to compare the endoscopic ultrasound (EUS) and the computed tomography (CT) and magnetic resonance imaging (MRI) findings of RMT and impact on cancer staging and resectability...
October 20, 2016: Gastrointestinal Endoscopy
Ambrose J Huang, Stijn A Bos, Martin Torriani, F Joseph Simeone, Connie Y Chang, Stuart R Pomerantz, Miriam A Bredella
OBJECTIVE: To evaluate the therapeutic value, safety, and long-term clinical outcomes of percutaneous lumbar facet synovial cyst (LFSC) rupture. MATERIALS AND METHODS: Our study was institutional review board (IRB)-approved and Health Insurance Portability and Accountability Act (HIPAA)-compliant. The study group comprised 71 patients (44 women, mean age: 65 ± 17 years) who underwent CT- or fluoroscopy-guided percutaneous LFSC rupture. The technical success of LFSC rupture, the long-term clinical outcome, including repeat procedures or surgery, and imaging findings on MRI and CT were recorded...
October 22, 2016: Skeletal Radiology
Christian Wybranski, Ilya Adamchic, Friedrich-Wilhelm Röhl, Jens Ricke, Frank Fischbach, Katharina Fischbach
OBJECTIVE: To assess the technical success and duration of magnetic resonance imaging (MRI)-guided freehand direct shoulder arthrography (FDSA) with near real-time imaging implemented in a routine shoulder MRI examination on an open 1.0-T MRI scanner, and to assess the learning curve of residents new to this technique. METHODS: An experienced MRI interventionalist (the expert) performed 125 MRI-guided FDSA procedures, and 75 patients were treated by one of three residents without previous experience in MRI-guided FDSA...
October 22, 2016: Skeletal Radiology
E Mazerand, N Karmani, L Le Fournier, L Laccourreye, H-D Fournier
INTRODUCTION: The image-guided transoral approach (IGTOA) provides a safe exposure to skull base midline lesions and the ventral aspect of the craniovertebral junction (CVJ). The IGTOA has several advantages: the head being placed in the extended position, it decreases the brainstem angulation during surgery; the approach being done through the avascular median pharyngeal raphe, not only lowers the bleeding risk but also provides a direct access to the bony pathology and granulation tissue accessible only via the ventral route...
October 19, 2016: Neuro-Chirurgie
Sungheon Gene Kim, Melanie Freed, Ana Paula Klautau Leite, Jin Zhang, Claudia Seuss, Linda Moy
PURPOSE: To assess the diagnostic utility of contrast kinetic analysis for breast lesions and background parenchyma of women undergoing MRI-guided biopsies, for whom standard clinical analysis had failed to separate benign and malignant lesions. MATERIALS AND METHODS: This study included 115 women who had indeterminate lesions based on routine diagnostic breast MRI exams and underwent an MRI (3 Tesla) -guided biopsy of one or more lesions suspicious for breast cancer...
October 20, 2016: Journal of Magnetic Resonance Imaging: JMRI
Marc Jansen, Sophie Em Veldhuijzen van Zanten, Dannis G Van Vuurden, Marc Huisman, Danielle J Vugts, Otto S Hoekstra, Guus A M S van Dongen, Gert-Jan Jl Kaspers
: Predictive tools to guide therapy in children with brain tumors are urgently needed. We introduced molecular imaging to facilitate this. We investigated whether bevacizumab can reach the tumor in children with diffuse intrinsic pontine glioma (DIPG) by measuring the tumor uptake of zirconium-89((89)Zr)-labeled bevacizumab by PET. In addition we evaluated the safety of the procedure in children and determined the optimal timing of imaging. METHODS: Patients received 0...
October 20, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Michael E Ivan, Roberto Jose Diaz, Michael H Berger, Gregory W Basil, David A Osiason, Thomas Plate, Amanda Wallo, Ricardo J Komotar
BACKGROUND AND OBJECTIVE: Magnetic resonance-guided laser-induced thermotherapy (MR-LITT) is a minimally invasive technique that shows promise in neuro-oncology due to its superiority in delivering precise minimally invasive thermal energy with minimal collateral damage. In this analysis we investigate initial data on MR-LITT's effect on dural based lesions. METHODS: Five patients were identified with dural based lesions (4 meningiomas, 1 solitary fibrous tumor) with clear evidence of radiological progression...
October 17, 2016: World Neurosurgery
Michael V Friedman, J Derek Stensby, Jeremiah R Long, Stephen A Currie, Travis J Hillen
PURPOSE: Review the MRI appearance of different bursae located throughout the pelvis, including the pertinent osseous and musculotendinous anatomy. MATERIALS AND METHODS: Bursae are potential spaces that reduce friction between opposed moving components which can become inflamed, clinically mimicking internal derangement. RESULTS: This series illustrates the most common as well as lesser-known pelvic bursae. Common causes of bursitis including overuse, trauma, and infection are presented...
September 28, 2016: Clinical Imaging
Anand Pandey, Vipin Gupta, Shailendra P Singh, Vijendra Kumar, Rajesh Verma
A trophic ulcer is a pressure ulcer caused by external trauma to a part of the body that is compromised due to disease, vascular insufficiency, or loss of afferent nerve fibers. Spinal dysraphism (ie, neural tube defects [NTD]) such as meningomyelocele is a risk factor for developing these ulcers in adults and pediatric patients. Information regarding the occurrence of trophic ulcers in pediatric patients with NTD is lacking. A review of the English-language literature on skin/neuropathic ulcers in patients with NTDs, irrespective of study design, published between 1975 and 2014, was undertaken using the PubMed database...
December 2015: Ostomy/wound Management
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