Investigative radiology
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Investigative radiology · Jun 2013
Magnetic resonance imaging-guided focused ultrasound treatment of symptomatic uterine fibroids: impact of technology advancement on ablation volumes in 115 patients.
The aim of this study was to assess the impact of the advanced technology of the new ExAblate 2100 system (Insightec Ltd, Haifa, Israel) for magnetic resonance imaging (MRI)-guided focused ultrasound surgery on treatment outcomes in patients with symptomatic uterine fibroids, as measured by the nonperfused volume ratio. ⋯ With technological advancement, the outcome of MRI-guided focused ultrasound treatment in terms of the nonperfused volume ratio can be enhanced with a high safety profile, markedly exceeding results reported in previous clinical trials.
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Investigative radiology · Jun 2013
Evolution of the ablation region after magnetic resonance-guided high-intensity focused ultrasound ablation in a Vx2 tumor model.
Volumetric magnetic resonance (MR)-guided high-intensity focused ultrasound (HIFU) is a completely noninvasive image-guided thermal ablation technique. Recently, there has been growing interest in the use of MR-HIFU for noninvasive ablation of malignant tumors. Of particular interest for noninvasive ablation of malignant tumors is reliable treatment monitoring and evaluation of response. At this point, there is limited evidence on the evolution of the ablation region after MR-HIFU treatment. The purpose of the present study was to comprehensively characterize the evolution of the ablation region after volumetric MR-HIFU ablation in a Vx2 tumor model using MR imaging, MR temperature data, and histological data. ⋯ During the first 3 days after MR-HIFU ablation, the ablation region increases in size, after which it gradually decreases in size. The NPA on CE-T1-w imaging underestimates the extent of tissue necrosis on histology in the initial few days, but after 1 week, the NPA is reliable in delineating the necrotic tissue area. The 240-EM thermal dose limit underestimates the necrotic tissue area immediately after MR-HIFU ablation. Reliable treatment evaluation techniques are particularly important for noninvasive, image-guided tumor ablation. Our results indicate that CE-T1-w imaging is reliable for MR-HIFU treatment evaluation after 1 week.
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Investigative radiology · May 2013
Optimizing positron emission tomography image acquisition protocols in integrated positron emission tomography/magnetic resonance imaging.
In integrated positron emission tomography (PET)/magnetic resonance imaging (MRI), the PET data acquisition is performed simultaneously to the magnetic resonance data acquisition, leaving latitude for the duration of PET acquisition time. This establishes emission time as an important parameter in forthcoming PET/MRI protocols because it is one of the key factors determining PET image quality. Thus, the purpose of the current study was to identify optimal duration of PET acquisition time in PET/MRI. ⋯ Positron emission tomography acquisition times on integrated PET/MRI do not need to exceed usual acquisition times on current PET/computed tomography scanners: Although the PET image quality suffers from short acquisition times, even a duration of 2 mpb permits sufficient lesion detection. Moreover, quantitative measures of tracer uptake are also reasonably precise at short acquisition times.
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Investigative radiology · May 2013
Metabolic mapping of gliomas using hybrid MR-PET imaging: feasibility of the method and spatial distribution of metabolic changes.
The most powerful adjunct to histopathology for the grading of gliomas seems to be the metabolic imaging using positron emission tomography and magnetic resonance spectroscopy (MRS). The purposes of this study were to examine the feasibility of simultaneous acquisition of both techniques for purposes of tumor grading in a newly launched hybrid magnetic resonance positron emission tomography (MR-PET) and to examine the spatial distributions of metabolic changes in gliomas. ⋯ Metabolic mapping before histological sampling is feasible using simultaneous MR-PET imaging. High T/N Met uptake ratio reflecting high expression of amino-acid membrane transporters, which is indicative of proliferating tumor cell populations, does not always spatially correlate with neuronal cell loss and cell membrane proliferation (Cho/NAA) seen in MRS. Increased Cr/NAA is associated with increased methionine uptake in low-grade gliomas, whereas normalized creatine in tumor tends to correlate with methionine accumulation, which indicates a possible coupling of these metabolic indices in anaplastic tumors. Thus, spatial distribution differences in gliomas should be taken into account when planning surgical sampling.
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Investigative radiology · May 2013
Integrated whole-body PET/MR hybrid imaging: clinical experience.
Integrated whole-body positron emission tomography (PET)/magnetic resonance (MR) scanners have recently been introduced and potentially offer new possibilities in hybrid imaging of oncologic patients. Integration of PET in a whole-body MR system requires new PET detector technology and new approaches to attenuation correction of PET data based on MR imaging. The aim of this study was to evaluate the clinical performance and image quality parameters of integrated whole-body PET/MR hybrid imaging in intraindividual comparison with PET/CT in oncologic patients. ⋯ Integrated PET/MR hybrid imaging is feasible in a clinical setting with similar detection rates as those of PET/CT. Attenuation correction can be performed sufficiently with Dixon sequences, although bone is disregarded. The administration of specific radiotracers and dedicated imaging sequences will foster this hybrid imaging modality in various indications.