Abductor tendon tears are associated with hypertrophy of the tensor fasciae latae muscle

Objective: To evaluate the association between hypertrophy of the tensor fasciae latae muscle and abductor tendon tears. Materials and methods: Thirty-five patients who underwent MRI of the abductor tendons of the hip were included in this retrospective study. A subgroup of 18 patients was examined bilaterally. The area of the tensor fasciae latae muscle and the area of the sartorius muscle (size reference) were quantified at the level of the femoral head, and a ratio was calculated. Two radiologists assessed the integrity of the gluteus medius and minimus tendon in consensus. Data were analyzed with a Mann-Whitney U test. Results: Sixteen out of 35 patients (46%) had a tear of the gluteus medius or minimus tendon. The ratio of the area of the tensor fasciae latae to the sartorius muscle was significantly higher (p = .028) in the group with an abductor tendon tear (median 2.25; Interquartile Range [IQR] = 1.97-3.21) compared to the group without any tears (median 1.91; IQR = 1.52-2.26). The bilateral subanalysis showed that in patients without a tear, the ratio of the two areas did not differ between each side (p = .966), with a median of 1.54 (primary side) and 1.76 (contralateral side). In patients with an abductor tendon tear the ratio was significantly higher (p = .031) on the side with a tear (median 2.81) compared to the contralateral healthy side (1.67). Conclusion: Patients with abductor tendon tears showed hypertrophy of the tensor fasciae latae muscle when compared to the contralateral healthy side and to patients without a tea

Consensus guidelines for the definition of time-to-event end points in image-guided tumor ablation: results of the SIO and DATECAN initiative

International audienceThere is currently no consensus regarding preferred clinical outcome measures following image-guided tumor ablation or clear definitions of oncologic end points. This consensus document proposes standardized definitions for a broad range of oncologic outcome measures with recommendations on how to uniformly document, analyze, and report outcomes. The initiative was coordinated by the Society of Interventional Oncology in collaboration with the Definition for the Assessment of Time-to-Event End Points in Cancer Trials, or DATECAN, group. According to predefined criteria, based on experience with clinical trials, an international panel of 62 experts convened. Recommendations were developed using the validated three-step modified Delphi consensus method. Consensus was reached on when to assess outcomes per patient, per session, or per tumor; on starting and ending time and survival time definitions; and on time-to-event end points. Although no consensus was reached on the preferred classification system to report complications, quality of life, and health economics issues, the panel did agree on using the most recent version of a validated patient-reported outcome questionnaire. This article provides a framework of key opinion leader recommendations with the intent to facilitate a clear interpretation of results and standardize worldwide communication. Widespread adoption will improve reproducibility, allow for accurate comparisons, and avoid misinterpretations in the field of interventional oncology research. Published under a CC BY 4.0 license. Online supplemental material is available for this article. See also the editorial by Liddell in this issue

Data from: Early treatment response in non-small cell lung cancer patients using diffusion-weighted imaging and functional diffusion maps - a feasibility study

Objective: The aim of this study was to prospectively evaluate the feasibility of monitoring treatment response to chemotherapy in patients with non-small cell lung carcinoma using functional diffusion maps (fDMs). Materials and Methods: This study was approved by the Cantonal Research Ethics Committee and informed written consent was obtained from all patients. Nine patients (mean age = 66 years; range = 53–76 years, 5 females, 4 males) with overall 13 lesions were included. Imaging was performed within two weeks before initiation of chemotherapy and at one, two, and six weeks after initiation of chemotherapy. Imaging included a respiratory-triggered diffusion-weighted sequence including three b-factors (100, 600, and 800 s/mm2). Treatment response was defined by change in tumor diameter on computed tomography (CT) after two cycles of chemotherapy. Changes in the apparent diffusion coefficient (ADC) on a per-lesion basis and the percentages of voxel with significantly increased or decreased ADCs on fDMs were analyzed using repeated measures analysis of variance (ANOVA). Changes in tumor size were used as covariate to examine the ability of ADCs and fDM parameters to predict treatment response. Results: Repeated measures ANOVA revealed that the percentage of voxels with increased ADCs on fDMs (p = 0.002) as well as the mean ADC increase (p = 0.011) were significantly higher in good responders with a large reduction in tumor size on CT. Conclusion: Our results indicate that the percentage of voxels with significantly increased ADCs on fDMs seems to be a promising biomarker for early prediction of treatment response in patients with non-small cell lung carcinoma. Contrary to averaged values, this approach allows the spatial heterogeneity of treatment response to be resolved

Early treatment response in non-small cell lung cancer patients using diffusion-weighted imaging and functional diffusion maps--a feasibility study.

OBJECTIVE: The aim of this study was to prospectively evaluate the feasibility of monitoring treatment response to chemotherapy in patients with non-small cell lung carcinoma using functional diffusion maps (fDMs). MATERIALS AND METHODS: This study was approved by the Cantonal Research Ethics Committee and informed written consent was obtained from all patients. Nine patients (mean age = 66 years; range = 53-76 years, 5 females, 4 males) with overall 13 lesions were included. Imaging was performed within two weeks before initiation of chemotherapy and at one, two, and six weeks after initiation of chemotherapy. Imaging included a respiratory-triggered diffusion-weighted sequence including three b-factors (100, 600, and 800 s/mm2). Treatment response was defined by change in tumor diameter on computed tomography (CT) after two cycles of chemotherapy. Changes in the apparent diffusion coefficient (ADC) on a per-lesion basis and the percentages of voxel with significantly increased or decreased ADCs on fDMs were analyzed using repeated measures analysis of variance (ANOVA). Changes in tumor size were used as covariate to examine the ability of ADCs and fDM parameters to predict treatment response. RESULTS: Repeated measures ANOVA revealed that the percentage of voxels with increased ADCs on fDMs (p = 0.002) as well as the mean ADC increase (p = 0.011) were significantly higher in good responders with a large reduction in tumor size on CT. CONCLUSION: Our results indicate that the percentage of voxels with significantly increased ADCs on fDMs seems to be a promising biomarker for early prediction of treatment response in patients with non-small cell lung carcinoma. Contrary to averaged values, this approach allows the spatial heterogeneity of treatment response to be resolved

Pilot study on the detection of antiandrogen resistance using serial diffusion-weighted imaging of bone metastases in prostate cancer

PURPOSE: To evaluate serial apparent diffusion coefficient (ADC) measurements of bone metastases in prostate cancer to determine whether antiandrogen resistance can be detected and time to progression estimated. MATERIALS AND METHODS: Diffusion-weighted imaging (DWI) was performed at 1.5T in nine patients with treatment-naïve metastatic prostate cancer (20 lesions) before antiandrogen treatment, after 1, 2, and 3 months of treatment, and thereafter every 4 months over 31 months or until antiandrogen resistance was detected. Tumor volumes were stable over time. Time courses of the ADCs when averaged over entire lesions and on functional diffusion maps (fDMs) were analyzed using marginal linear model (MLM) analysis. RESULTS: Starting at 1 month, MLM analysis revealed decreasing mean ADCs (P = 0.001) over time. Simultaneously, the percentage of voxels with significantly higher ADCs decreased (P = 0.004), whereas the percentage of voxels with significantly lower ADCs increased (P < 0.001) on fDMs. Both mean ADCs (P = 0.042) and percentages of voxels with significantly higher ADCs on fDMs (P = 0.039) decreased more rapidly over time in patients with a shorter progression-free interval (PFI). Likewise, higher (P = 0.001) and more rapidly increasing (P = 0.002) percentages of voxels with significantly lower ADCs on fDMs were associated with a shorter PFI. CONCLUSION: The results of our pilot study suggest that the evolution of ADCs over time may permit early identification of antiandrogen resistance in bone metastases. J. Magn. Reson. Imaging 2015

Spiral 3D time-of-flight MR angiography for rapid non-contrast carotid artery imaging:Clinical feasibility and protocol optimization

PURPOSE: To assess the clinical feasibility of spiral 3D Time-Of-Flight (TOF) MR Angiography (MRA) sequence variants for rapid non-contrast carotid artery imaging.METHODS: Nine different 3D TOF MRA sequences were acquired in nine healthy volunteers on a standard clinical 1.5 T scanner. Three cartesian sequences (fully sampled (10:15 min), accelerated with SENSE (05:08 min), accelerated with Compressed SENSE (03:32 min)) and six different spiral sequences were acquired (spiral acquisition windows ranging from 10 to 5 ms (01:32 min-03:05 min)). Three readers graded the images qualitatively in terms of overall image quality, vessel sharpness, inhomogeneous intraluminal signal, background noise, visualization of large and small vessels and overall impression of the number of visible vessels. Cross-sectional areas of the vessel lumen were measured and vessel sharpness was quantified.RESULTS: The SENSE and Compressed SENSE accelerated cartesian sequences and the Spiral 6 ms and 5 ms sequences were deemed comparable to the fully sampled cartesian sequence in most qualitative categories (p &gt; 0.05) based on exact binomial tests. The Spiral 6 ms and 5 ms sequences achieved a scan time reduction of 75.3% and 69.9% respectively compared to the fully sampled cartesian sequence. The spiral sequences (generally) exhibited improved subjective vessel sharpness (p &lt; 0.01-p = 0.13) but increased background noise (p = 0.03-p = 0.25). Cross-sectional area measurements were similar between all sequences (Krippendorff's alpha: 0.955-0.982). Quantitative vessel sharpness was increased for all spiral sequences compared to all cartesian sequences (p = 0.004).CONCLUSIONS: Spiral 3D TOF MRA sequences with a spiral acquisition window of 5 ms or 6 ms may be used for accurate, rapid, clinical non-contrast carotid artery imaging.</p

Longitudinal Lung Cancer Data

The zip-File includes all longitudinal MR data files for each patient separately which were used to determine treatment monitoring in non-small cell lung cancer patients using diffusion-weighted imaging and functional diffusion maps. The detailed scan parameters and acquisition time points can be found in the manuscript

Overview of MRI sequence parameters.

<p>Note: GE = gradient echo, SE = spin echo, SPIR = spectral presaturation with inversion recovery. All sequences were axial and two-dimensional.</p><p>*This sequence was performed with b-values of 100, 600, and 800 s/mm² and a parallel imaging reduction factor of 1.8. The actual repetition and scan times were longer due to navigator triggering.</p><p>Overview of MRI sequence parameters.</p

Pie charts showing the percentages of voxels on fDMs that featured significantly increased (red voxels), significantly decreased (blue voxels) or unchanged (green voxels) ADCs under therapy averaged over all lesions.

<p>The percentages at <b>(a)</b> one, <b>(b)</b> two, and <b>(c)</b> six weeks after treatment onset are depicted separately for patients that showed partial response (first row) and stable disease (second row), respectively. The percentage of voxels with significantly increased ADCs in comparison to pretreatment values was significantly higher in lesions that showed a large decrease in tumor size on CT after two cycles of chemotherapy (p = 0.041).</p

FDMs of the two lesions in patient 7 which showed a moderate decrease in tumor size under chemotherapy.

<p><b>(a)</b> Pretreatment ADC map showing the ROIs circumscribing the tumors and fDMs at, <b>(b)</b> one, <b>(c)</b> two, and <b>(d)</b> six weeks after treatment onset superimposed onto the corresponding posttreatment ADC map. The scatterplots of pretreatment versus posttreatment voxel values over the entire lesions are shown below each image. Dashed lines = threshold beyond which a significant ADC change is deemed to have occurred. Few voxels feature significantly increased ADCs relative to the pretreatment values.</p