Whole-body MRI in pediatric patients with cancer

Cancer is the leading cause of natural death in the pediatric populations of developed countries, yet cure rates are greater than 70% when a cancer is diagnosed in its early stages. Recent advances in magnetic resonance imaging methods have markedly improved diagnostic and therapeutic approaches, while avoiding the risks of ionizing radiation that are associated with most conventional radiological methods, such as computed tomography and positron emission tomography/computed tomography. The advent of whole-body magnetic resonance imaging in association with the development of metabolic- and function-based techniques has led to the use of whole-body magnetic resonance imaging for the screening, diagnosis, staging, response assessment, and post-therapeutic follow-up of children with solid sporadic tumours or those with related genetic syndromes. Here, the advantages, techniques, indications, and limitations of whole-body magnetic resonance imaging in the management of pediatric oncology patients are presented.AC Camargo Canc Ctr, Dept Imaging, Rua Prof Antonio Prudente 211, BR-01509010 Sao Paulo, SP, BrazilUniv Fed Vale Sao Francisco UNIVASF, Av Jose Sa Manicoba, BR-56304917 Petrolina, PE, BrazilAC Camargo Canc Ctr, Dept Imaging, Rua Prof Antonio Prudente 211, BR-01509010 Sao Paulo, SP, BrazilUniv Sao Paulo, Ribeirao Preto Med Sch, Div Radiol, Dept Internal Med, Av Bandeirantes 3900, BR-14049090 Ribeirao Preto, SP, BrazilUniv Fed Sao Paulo, Dept Diagnost Imagem, Disciplina Diagnost Imagem Pediat, Rua Napoleao de Barros 800, BR-04024002 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Ctr Diagnost Imagem, Inst Oncol Pediat & Med Radiol, Inst Oncol Pediat, Rua Napoleao Barros 800, BR-04024002 Sao Paulo, SP, BrazilUniv Texas MD Anderson Canc Ctr, Dept Diagnost Radiol, 1515 Holcombe Blvd, Houston, TX 77030 USAUniv Fed Ciencias Saude Porto Alegre, Dept Radiol, Ctr Hist, Rua Prof Anes Dias 285, BR-90020090 Porto Alegre, RS, BrazilUniv Fed Rio de Janeiro, Dept Radiol, Rua Thomaz Cameron 438, BR-25685129 Petropolis, RJ, BrazilUniv Fed Sao Paulo, Dept Diagnost Imagem, Disciplina Diagnost Imagem Pediat, Rua Napoleao de Barros 800, BR-04024002 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Ctr Diagnost Imagem, Inst Oncol Pediat & Med Radiol, Inst Oncol Pediat, Rua Napoleao Barros 800, BR-04024002 Sao Paulo, SP, BrazilWeb of Scienc

Pulmonary thromboembolism: new diagnostic imaging techniques

<div><p>Abstract The accurate diagnosis of pulmonary thromboembolism is essential to reducing the morbidity and mortality associated with the disease. The diagnosis of pulmonary thromboembolism is challenging because of the nonspecific nature of the clinical profile and the risk factors. Imaging methods provide the definitive diagnosis. Currently, the imaging method most commonly used in the evaluation of pulmonary thromboembolism is computed tomography. The recent development of dual-energy computed tomography has provided a promising tool for the evaluation of pulmonary perfusion through iodine mapping. In this article, we will review the importance of diagnosing pulmonary thromboembolism, as well as the imaging methods employed, primarily dual-energy computed tomography.</p></div

Pulmonary thromboembolism: new diagnostic imaging techniques

<div><p>Abstract The accurate diagnosis of pulmonary thromboembolism is essential to reducing the morbidity and mortality associated with the disease. The diagnosis of pulmonary thromboembolism is challenging because of the nonspecific nature of the clinical profile and the risk factors. Imaging methods provide the definitive diagnosis. Currently, the imaging method most commonly used in the evaluation of pulmonary thromboembolism is computed tomography. The recent development of dual-energy computed tomography has provided a promising tool for the evaluation of pulmonary perfusion through iodine mapping. In this article, we will review the importance of diagnosing pulmonary thromboembolism, as well as the imaging methods employed, primarily dual-energy computed tomography.</p></div

When to Biopsy the Seminal Vesicles: A Validated Multiparametric Magnetic Resonance Imaging and Target Driven Model to Detect Seminal Vesicle Invasion of Prostate Cancer

© 2019 by American Urological Association Education and Research, Inc. Purpose:Current imaging and biopsy practices offer limited insight into preoperative detection of seminal vesicle invasion despite the implications for treatment decisions and patient prognoses. We identified magnetic resonance imaging features to assess the risk of seminal vesicle invasion and inform the inclusion of seminal vesicle sampling during biopsy.Materials and Methods:Patients underwent multiparametric magnetic resonance imaging and fusion targeted biopsy with or without seminal vesicle biopsy. Magnetic resonance imaging suspicion of seminal vesicle invasion, multiparametric magnetic resonance imaging of prostate base lesions of moderate or greater suspicion, extraprostatic extension, anatomical zone and biopsy data were used to generate multivariable logistic regression models. One model without and one with biopsy data were externally validated in a multi-institutional cohort. Decision curve analyses were done to determine net benefit of the 2 models.Results:The training and validation cohorts comprised 564 and 250 patients, respectively. In the training cohort 55 patients (9.8%) had pathologically confirmed seminal vesicle invasion. In the prebiopsy model magnetic resonance imaging suspicion of seminal vesicle invasion (OR 9.5, 95% CI 4.0-22.4, p \u3c0.001), multiparametric magnetic resonance imaging base lesions of moderate or greater suspicion with extraprostatic extension (OR 13.6, 95% CI 4.0-46.5, p \u3c0.001), and a transition and/or central zone location (OR 11.6, 95% CI 3.5-38.3, p \u3c0.001) showed strong correlations. In the post-biopsy model the risk of pathologically confirmed seminal vesicle invasion increased with the base Gleason Group (Gleason Group 5 OR 85.3, 95% CI 11.8-619.1, p \u3c0.001). In the validation cohort the AUC of the prebiopsy and post-biopsy models was 0.84 and 0.93, respectively (p = 0.030).Conclusions:Magnetic resonance imaging evidence of seminal vesicle invasion or extraprostatic extension at the prostate base transition and/or central zone and high grade prostate cancer from the prostate base are significant features associated with an increased risk of pathologically confirmed seminal vesicle invasion. Our models successfully incorporated these features to predict seminal vesicle invasion and inform when to biopsy the seminal vesicles