Radiology
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Compared with mammography and breast ultrasonography, contrast material-enhanced magnetic resonance (MR) imaging is a breast imaging technique that offers not only information on lesion cross-sectional morphology but also on functional lesion features such as tissue perfusion and enhancement kinetics. After an enthusiastic start to clinical breast MR imaging in the early 1990s, a variety of difficulties and obstacles were identified that hampered the transfer of the modality into clinical practice, including a lack of standardization regarding image acquisition and interpretation guidelines, a lack of MR-compatible interventional materials, and a lack of evidence regarding its diagnostic accuracy--particularly specificity and positive predictive value, as well as sensitivity for ductal carcinoma in situ. This article is the first of two on the current status of breast MR imaging. ⋯ Advantages and disadvantages of different pulse sequence parameters are discussed to help radiologists make a balanced and informed decision regarding choice of image acquisition protocol. Imaging findings in common benign and malignant changes are described, and current concepts for differential diagnosis, including the MR Breast Imaging Reporting and Data System lexicon, are discussed. Furthermore, obstacles that impeded the technique's transfer into clinical practice are discussed, and the progress made in recent years, especially regarding the development of guidelines, procedural standardization, and MR-guided interventions are outlined.
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To retrospectively compare in patients with chronic hypersensitivity pneumonitis (HP) the computed tomographic (CT) imaging features suggestive of fibrosis with pathologic evidence of fibrosis at surgical lung biopsy and to compare a usual interstitial pneumonia (UIP) pattern at CT with survival. ⋯ CT findings of extensive reticular pattern, traction bronchiectasis, and honeycombing are closely related to the presence of histologic fibrosis in chronic HP.
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To prospectively determine the accuracy of positron emission tomography (PET)/computed tomography (CT) with added CT morphologic information for depiction of metastases in patients with high-risk melanoma and negative findings for metastases at PET, by using histologic findings or additional imaging and/or follow-up findings as reference standard. ⋯ Dedicated analysis of coregistered CT images significantly improves the accuracy of integrated PET/CT for depiction of metastases in patients with high-risk melanoma.
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To prospectively determine whether differences between benign and malignant brain lesions can be depicted with fluorine 18 ((18)F) fluorocholine positron emission tomography (PET). ⋯ High-grade gliomas, metastases, and benign lesions can be distinguished on the basis of measured fluorocholine uptake. Increased peritumoral fluorocholine uptake is a distinguishing characteristic of high-grade gliomas.