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MRI GUIDELINES

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https://www.readbyqxmd.com/read/28531188/monitoring-tumor-response-to-neoadjuvant-chemotherapy-using-mri-and-18f-fdg-pet-ct-in-breast-cancer-subtypes
#1
Alexander M Th Schmitz, Suzana C Teixeira, Kenneth E Pengel, Claudette E Loo, Wouter V Vogel, Jelle Wesseling, Emiel J Th Rutgers, Renato A Valdés Olmos, Gabe S Sonke, Sjoerd Rodenhuis, Marie Jeanne T F D Vrancken Peeters, Kenneth G A Gilhuijs
PURPOSE: To explore guidelines on the use of MRI and PET/CT monitoring primary tumor response to neoadjuvant chemotherapy (NAC), taking breast cancer subtype into account. MATERIALS AND METHODS: In this prospective cohort study, 188 women were included with stages II and III breast cancer. MRI and 18F-FDG-PET/CT were acquired before and during NAC. Baseline pathology was assessed from tumor biopsy. Tumors were stratified into HER2-positive, ER-positive/HER2-negative (ER-positive), and ER-negative/PR-negative/HER2-negative (triple-negative) subtypes, and treated according to subtype...
2017: PloS One
https://www.readbyqxmd.com/read/28512732/decision-making-in-the-surgical-management-of-invasive-breast-cancer-part-1-lumpectomy-mastectomy-and-contralateral-prophylactic-mastectomy
#2
REVIEW
Lisa A Newman
Several prospective randomized clinical trials conducted internationally have proven the safety and survival equivalence of breast-conserving surgery compared with mastectomy. Adjuvant radiation is routinely recommended following lumpectomy surgery to minimize the risk of local recurrence. Comprehensive breast imaging (including bilateral mammography with diagnostic views and ultrasound evaluation), in addition to clinical examination, is essential to rule out potential contralateral pathology and to optimally characterize the extent of disease...
May 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28511220/-significance-and-value-of-psma-ligands-in-prostate-cancer
#3
Claudia Gasch, Stefan Körber, Christophe Kremer, Matthias Eiber, Clemens Kratochwil, Uwe Haberkorn, Markus Hohenfellner, Boris Hadaschik, Frederik L Giesel
In recent years, PSMA-targeting PET tracers such as (68)Ga-PSMA-11 have shown promising results, thus contributing to a better management of prostate cancer patients. At the present time, (68)Ga-PSMA-11 is most frequently used for diagnostic evaluation in the setting of biochemical recurrence of prostate cancer. In this context, the (68)Ga-PSMA-11 PET/CT delivers superior detection rates compared to conventional imaging, especially for the detection of small, unsuspicious lesions or lesions in the presence of low PSA values...
April 2017: Aktuelle Urologie
https://www.readbyqxmd.com/read/28494579/multiparametric-prostate-mri-technical-conduct-standardized-report-and-clinical-use-a-narrative-review
#4
Matteo Manfredi, Fabrizio Mele, Diletta Garrou, Jochen Walz, Jurgen J Fütterer, Filippo Russo, Lorenzo Vassallo, Arnauld Villers, Mark Emberton, Massimo Valerio
Multiparametric prostate MRI (mp-MRI) is an emerging imaging modality for diagnosis, characterization, staging, and treatment planning of prostate cancer (PCa). The technique, results reporting, and its role in clinical practice have been the subject of significant development over the last decade. Although mp-MRI is not yet routinely used in the diagnostic pathway, almost all urological guidelines have emphasized the potential role of mp-MRI in several aspects of PCa management. Moreover, new MRI sequences and scanning techniques are currently under evaluation to improve the diagnostic accuracy of mp-MRI...
May 11, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/28487150/opening-of-calcium-activated-potassium-channels-improves-long-term-left-ventricular-function-after-coronary-artery-occlusion-in-mice
#5
Friederike Behmenburg, Nina Hölscher, Ulrich Flögel, Markus W Hollmann, André Heinen, Ragnar Huhn
BACKGROUND: Opening of mitochondrial calcium-activated potassium channels (BKCa) reduces infarct size after myocardial ischemia/reperfusion injury (I/R). It is unknown if targeting BKCa-channels improves cardiac performance in the long-term after I/R. METHODS: Experiments were conducted in compliance with institutional and national guidelines in C57BL/6 mice (n=7-8/group). Animals were randomized into two groups. Preconditioning was induced by intraperitoneal application of NS1619 (NS, 1μg/g bw) 10min before ischemia, control animals (Con) received the vehicle...
April 27, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28482329/endometrial-changes-during-ulipristal-acetate-use-a-systematic-review
#6
REVIEW
Inge De Milliano, Dominique Van Hattum, Johannes C F Ket, Judith A F Huirne, Wouter J K Hehenkamp
Ulipristal acetate is increasingly used for several clinical indications, like emergency contraception and pre-treatment of uterine fibroids. It has mixed progesterone agonist and antagonist effects in the myometrium and endometrium. Due to its progesterone antagonistic effect, an unopposed estrogen effect could occur which could cause (pre-)malignant lesions in the endometrium. Several studies have been performed to evaluate this possible increased risk for endometrial malignancies when using ulipristal acetate...
April 28, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28473092/acr-appropriateness-criteria-%C3%A2-suspected-pulmonary-hypertension
#7
Arlene Sirajuddin, Edwin F Donnelly, Traves P Crabtree, Travis S Henry, Mark D Iannettoni, Geoffrey B Johnson, Ella A Kazerooni, Fabien Maldonado, Kathryn M Olsen, Carol C Wu, Tan-Lucien Mohammed, Jeffrey P Kanne
Pulmonary hypertension may be idiopathic or related to a large variety of diseases. Various imaging examinations that may be helpful in diagnosing and determining the etiology of pulmonary hypertension are discussed. Imaging examinations that may aid in the diagnosis of pulmonary hypertension include chest radiography, ultrasound echocardiography, ventilation/perfusion scans, CT, MRI, right heart catheterization, pulmonary angiography, and fluorine-18-2-fluoro-2-deoxy-d-glucose PET/CT. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473091/acr-appropriateness-criteria-%C3%A2-cerebrovascular%C3%A2-disease
#8
Michael B Salmela, Shabnam Mortazavi, Bharathi D Jagadeesan, Daniel F Broderick, Judah Burns, Tejaswini K Deshmukh, H Benjamin Harvey, Jenny Hoang, Christopher H Hunt, Tabassum A Kennedy, Alexander A Khalessi, William Mack, Nandini D Patel, Joel S Perlmutter, Bruno Policeni, Jason W Schroeder, Gavin Setzen, Matthew T Whitehead, Rebecca S Cornelius, Amanda S Corey
Diseases of the cerebral vasculature represent a heterogeneous group of ischemic and hemorrhagic etiologies, which often manifest clinically as an acute neurologic deficit also known as stroke or less commonly with symptoms such as headache or seizures. Stroke is the fourth leading cause of death and is a leading cause of serious long-term disability in the United States. Eighty-seven percent of strokes are ischemic, 10% are due to intracerebral hemorrhage, and 3% are secondary to subarachnoid hemorrhage. The past two decades have seen significant developments in the screening, diagnosis, and treatment of ischemic and hemorrhagic causes of stroke with advancements in CT and MRI technology and novel treatment devices and techniques...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473089/acr-appropriateness-criteria-%C3%A2-suspected-osteomyelitis-septic-arthritis-or-soft-tissue-infection-excluding-spine-and-diabetic-foot
#9
Francesca D Beaman, Paul F von Herrmann, Mark J Kransdorf, Ronald S Adler, Behrang Amini, Marc Appel, Erin Arnold, Stephanie A Bernard, Bennett S Greenspan, Kenneth S Lee, Michael J Tuite, Eric A Walker, Robert J Ward, Daniel E Wessell, Barbara N Weissman
Infection of the musculoskeletal system is a common clinical problem. Differentiating soft tissue from osseous infection often determines the appropriate clinical therapeutic course. Radiographs are the recommend initial imaging examination, and although often not diagnostic in acute osteomyelitis, can provide anatomic evaluation and alternative diagnoses influencing subsequent imaging selection and interpretation. MRI with contrast is the examination of choice for the evaluation of suspected osteomyelitis, and MRI, CT, and ultrasound can all be useful in the diagnosis of soft tissue infection...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473088/acr-appropriateness-criteria-%C3%A2-suspected-liver%C3%A2-metastases
#10
Harmeet Kaur, Nicole M Hindman, Waddah B Al-Refaie, Hina Arif-Tiwari, Brooks D Cash, Victoria Chernyak, James Farrell, Joseph R Grajo, Jeanne M Horowitz, Michelle M McNamara, Richard B Noto, Aliya Qayyum, Tasneem Lalani, Ihab R Kamel
Liver metastases are the most common malignant liver tumors. The accurate and early detection and characterization of liver lesions is the key to successful treatment strategies. Increasingly, surgical resection in combination with chemotherapy is effective in significantly improving survival if all metastases are successfully resected. MRI and multiphase CT are the primary imaging modalities in the assessment of liver metastasis, with the relative preference toward multiphase CT or MRI depending upon the clinical setting (ie, surveillance or presurgical planning)...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473086/acr-appropriateness-criteria-%C3%A2-stress-fatigue-insufficiency-fracture-including-sacrum-%C3%A2-excluding-other-vertebrae
#11
Jenny T Bencardino, Taylor J Stone, Catherine C Roberts, Marc Appel, Steven J Baccei, R Carter Cassidy, Eric Y Chang, Michael G Fox, Bennett S Greenspan, Soterios Gyftopoulos, Mary G Hochman, Jon A Jacobson, Douglas N Mintz, Gary W Mlady, Joel S Newman, Zehava S Rosenberg, Nehal A Shah, Kirstin M Small, Barbara N Weissman
Stress fractures, including both fatigue and insufficiency types, are frequently encountered in clinical practice as a source of pain in both athletes and patients with predisposing conditions. Radiography is the imaging modality of choice for baseline diagnosis. MRI has greatly improved our ability to diagnose radiographically occult stress fractures. Tc-99m bone scan and CT may also be useful as diagnostic tools. Although fatigue and insufficiency fractures can be self-limited and go onto healing even without diagnosis, there is usually value in initiating prompt therapeutic measures as incomplete stress fractures have the potential of progressing to completion and requiring more invasive treatment or delay in return to activity...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473085/acr-appropriateness-criteria-%C3%A2-stage-i-breast-cancer-initial-workup-and-surveillance-for-local-recurrence-and-distant-metastases-in-asymptomatic-women
#12
Linda Moy, Lisa Bailey, Carl D'Orsi, Edward D Green, Anna I Holbrook, Su-Ju Lee, Ana P Lourenco, Martha B Mainiero, Karla A Sepulveda, Priscilla J Slanetz, Sunita Trikha, Monica M Yepes, Mary S Newell
Women and health care professionals generally prefer intensive follow-up after a diagnosis of breast cancer. However, there are no survival differences between women who obtain intensive surveillance with imaging and laboratory studies compared with women who only undergo testing because of the development of symptoms or findings on clinical examinations. American Society of Clinical Oncology and National Comprehensive Cancer Network guidelines state that annual mammography is the only imaging examination that should be performed to detect a localized breast recurrence in asymptomatic patients; more imaging may be needed if the patient has locoregional symptoms (eg, palpable abnormality)...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473084/acr-appropriateness-criteria-%C3%A2-renal-transplant%C3%A2-dysfunction
#13
Myles T Taffel, Paul Nikolaidis, Michael D Beland, M Donald Blaufox, Vikram S Dogra, Stanley Goldfarb, John L Gore, Howard J Harvin, Marta E Heilbrun, Matthew T Heller, Gaurav Khatri, Glenn M Preminger, Andrei S Purysko, Andrew D Smith, Zhen J Wang, Robert M Weinfeld, Jade J Wong-You-Cheong, Erick M Remer, Mark E Lockhart
Renal transplantation is the treatment of choice in patients with end-stage renal disease because the 5-year survival rates range from 72% to 99%. Although graft survival has improved secondary to the introduction of newer immunosuppression drugs and the advancements in surgical technique, various complications still occur. Ultrasound is the first-line imaging modality for the evaluation of renal transplants in the immediate postoperative period and for long-term follow-up. In addition to depicting many of the potential complications of renal transplantation, ultrasound can also guide therapeutic interventions...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473080/acr-appropriateness-criteria-%C3%A2-prostate-cancer-pretreatment-detection-surveillance-and%C3%A2-staging
#14
Fergus V Coakley, Aytekin Oto, Lauren F Alexander, Brian C Allen, Brian J Davis, Adam T Froemming, Pat F Fulgham, Keyanoosh Hosseinzadeh, Christopher Porter, V Anik Sahni, David M Schuster, Timothy N Showalter, Aradhana M Venkatesan, Sadhna Verma, Carolyn L Wang, Erick M Remer, Steven C Eberhardt
Despite the frequent statement that "most men die with prostate cancer, not of it," the reality is that prostate cancer is second only to lung cancer as a cause of death from malignancy in American men. The primary goal during baseline evaluation of prostate cancer is disease characterization, that is, establishing disease presence, extent (local and distant), and aggressiveness. Prostate cancer is usually diagnosed after the finding of a suspicious serum prostate-specific antigen level or digital rectal examination...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473079/acr-appropriateness-criteria-%C3%A2-pretreatment%C3%A2-staging-of-colorectal-cancer
#15
Kathryn J Fowler, Harmeet Kaur, Brooks D Cash, Barry W Feig, Kenneth L Gage, Evelyn M Garcia, Amy K Hara, Joseph M Herman, David H Kim, Drew L Lambert, Angela D Levy, Christine M Peterson, Christopher D Scheirey, William Small, Martin P Smith, Tasneem Lalani, Laura R Carucci
Colorectal cancers are common tumors in the United States and appropriate imaging is essential to direct appropriate care. Staging and treatment differs between tumors arising in the colon versus the rectum. Local staging for colon cancer is less integral to directing therapy given radical resection is often standard. Surgical options for rectal carcinoma are more varied and rely on accurate assessment of the sphincter, circumferential resection margins, and peritoneal reflection. These important anatomic landmarks are best appreciated on high-resolution imaging with transrectal ultrasound or MRI...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473078/acr-appropriateness-criteria-%C3%A2-plexopathy
#16
Julie Bykowski, Joseph M Aulino, Kevin L Berger, R Carter Cassidy, Asim F Choudhri, A Tuba Kendi, Claudia F E Kirsch, Michael D Luttrull, Aseem Sharma, Vilaas S Shetty, Khoi Than, Christopher J Winfree, Rebecca S Cornelius
MRI without and with contrast is the most accurate imaging method to determine whether a process is intrinsic or extrinsic to a nerve of the brachial or lumbosacral plexus. However, there are no Current Procedural Terminology codes to correspond to imaging studies of the brachial or lumbar plexus discretely. This assessment uses "MRI of the brachial plexus" or "MRI of the lumbosacral plexus" as independent entities given that imaging acquisition for the respective plexus differs in sequences and planes compared with those of a routine neck, chest, spine, or pelvic MRI, yet acknowledges the potential variability of ordering practices across institutions...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473077/acr-appropriateness-criteria-%C3%A2-palpable-breast%C3%A2-masses
#17
Linda Moy, Samantha L Heller, Lisa Bailey, Carl D'Orsi, Roberta M DiFlorio, Edward D Green, Anna I Holbrook, Su-Ju Lee, Ana P Lourenco, Martha B Mainiero, Karla A Sepulveda, Priscilla J Slanetz, Sunita Trikha, Monica M Yepes, Mary S Newell
Breast cancer is the most common female malignancy and the second leading cause of female cancer death in the United States. Although the majority of palpable breast lumps are benign, a new palpable breast mass is a common presenting sign of breast cancer. Any woman presenting with a palpable lesion should have a thorough clinical breast examination, but because many breast masses may not exhibit distinctive physical findings, imaging evaluation is necessary in almost all cases to characterize the palpable lesion...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473073/acr-appropriateness-criteria-%C3%A2-known-or-suspected-congenital-heart-disease-in-the-adult
#18
Pamela K Woodard, Vincent B Ho, Scott R Akers, Garth Beache, Richard K J Brown, Kristopher W Cummings, S Bruce Greenberg, James K Min, Arthur E Stillman, Jadranka Stojanovska, Jill E Jacobs
The incidence of congenital heart disease (CHD) has been increasing in the adult patient population in part as a result of better patient survival. Patients with more severe CHD are living longer. Nearly all adults with known CHD require periodic imaging as a means of monitoring their disease process. Furthermore, adult patients with suspected CHD require imaging as a means of definitive diagnosis. As a result, it is important for both the referring clinician and the imager to be aware of the most appropriate imaging modality needed to obtain the data most needed to direct the next steps in patient care...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473071/acr-appropriateness-criteria-%C3%A2-hematospermia
#19
Keyanoosh Hosseinzadeh, Aytekin Oto, Brian C Allen, Fergus V Coakley, Barak Friedman, Pat F Fulgham, Matthew S Hartman, Matthew T Heller, Christopher Porter, V Anik Sahni, Gary S Sudakoff, Sadhna Verma, Carolyn L Wang, Don C Yoo, Erick M Remer, Steven C Eberhardt
Most men with hematospermia or hemospermia (HS) are young (<40 years of age), presenting with transient or episodic HS without other signs or symptoms of disease. The condition is self-limiting in most cases and idiopathic in nature. When a cause can be identified, infections of the urogenital tract are the most common. Imaging does not play a role in this patient population. In older men (>40 years of age), clinical screening for prostate cancer is advised. Furthermore, when HS is persistent or has symptoms, causes include obstruction or stricture at the level of the verumontanum, calcifications or calculi in the prostate, ejaculatory ducts or seminal vesicles, and cysts arising within these structures...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473070/acr-appropriateness-criteria-%C3%A2-evaluation-of-nipple-discharge
#20
Su-Ju Lee, Sunita Trikha, Linda Moy, Paul Baron, Roberta M diFlorio, Edward D Green, Samantha L Heller, Anna I Holbrook, Alana A Lewin, Ana P Lourenco, Bethany L Niell, Priscilla J Slanetz, Ashley R Stuckey, Nina S Vincoff, Susan P Weinstein, Monica M Yepes, Mary S Newell
Appropriate imaging evaluation of nipple discharge depends the nature of the discharge. Imaging is not indicated for women with physiologic nipple discharge. For evaluation of pathologic nipple discharge, multiple breast imaging modalities are rated for evidence-based appropriateness under various scenarios. For women age 40 or older, mammography or digital breast tomosynthesis (DBT) should be the initial examination. Ultrasound is usually added as a complementary examination, with some exceptions. For women age 30 to 39, either mammogram or ultrasound may be used as the initial examination on the basis of institutional preference...
May 2017: Journal of the American College of Radiology: JACR
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