Comparison of 1.0 M gadobutrol and 0.5 M gadopentate dimeglumine-enhanced MRI in 471 patients with known or suspected renal lesions: Results of a multicenter, single-blind, interindividual, randomized clinical phase III trial

The purpose of this phase III clinical trial was to compare two different extracellular contrast agents, 1.0 M gadobutrol and 0.5 M gadopentate dimeglumine, for magnetic resonance imaging (MRI) in patients with known or suspected focal renal lesions. Using a multicenter, single-blind, interindividual, randomized study design, both contrast agents were compared in a total of 471 patients regarding their diagnostic accuracy, sensitivity, and specificity to correctly classify focal lesions of the kidney. To test for noninferiority the diagnostic accuracy rates for both contrast agents were compared with CT results based on a blinded reading. The average diagnostic accuracy across the three blinded readers ('average reader') was 83.7% for gadobutrol and 87.3% for gadopentate dimeglumine. The increase in accuracy from precontrast to combined precontrast and postcontrast MRI was 8.0% for gadobutrol and 6.9% for gadopentate dimeglumine. Sensitivity of the average reader was 85.2% for gadobutrol and 88.7% for gadopentate dimeglumine. Specificity of the average reader was 82.1% for gadobutrol and 86.1% for gadopentate dimeglumine. In conclusion, this study documents evidence for the noninferiority of a single i.v. bolus injection of 1.0 M gadobutrol compared with 0.5 M gadopentate dimeglumine in the diagnostic assessment of renal lesions with CE-MRI

[Current role of lymphography in the study of systemic lymphatic diseases]

The usefulness and reliability of lymphography for staging purposes in Hodgkin's disease are discussed with reference to a personal series

Angiography in chronic pancreatitis and pancreatic cancer. A critical evaluation

A critical "blind" evaluation of 129 randomly selected angiographic examinations was carried out including 37 control patients, 58 patients affected by proven chronic relapsing pancreatitis and 34 patients with cancer of the pancreas. In 48.5% of the control patients a completely normal angiographic picture was found. The false positives were found in 10.8% of chronic pancreatitis and in pancreatic carcinoma in 5.5% of the cases. Equivocal signs were found in 35.2%. The percentage of the false negative results in chronic pancreatitis was 34.4% (of which 8.6% were suggestive of pancreatic cancer). In pancreatic cancer positive results were seen in 70.6% of the cases. The percentage of the false negatives was 26.5% (suggestive of chronic pancreatitis); equivocal signs were found in 2.9% of these patients. Notwithstanding the not-negligible percentage of errors, angiography can be usefully employed in diagnosis of pancreatic disorders

The mummy of Cangrande della Scala lord of Verona(1291-1329): A case of Medieval acute Digitalis intoxication

Cangrande della Scala (1291-1329), lord of Verona, suddenly died of acute diarrheic illness on 22 July 1329, after the conquest of the city of Treviso and of a large part of Northern Italy. Imaging (digital X-ray and CAT) and autopsy studies of the well-preserved natural mummy of Cangrande showed a good preservation of the internal organs and liver, as well as the feces in the rectum. Histology evidenced liver fibrosis and a severe irregular lung emphysema, with nodular fibrosis and massive anthracosis. Immunochemical analysis of extracts of feces and liver revealed the presence of toxic concentrations of digoxin and digitoxin, equivalent to several dozens of nanograms per gram, with presence of Digitalis pollen in the feces. Administration of a brew or foxglove decoction designed to cure or, more likely, to poison the prince, was almost certainly responsible for this acute and fatal intoxication