Feasibility study of computed vs measured high b-value(1400 s/mm2) diffusion-weighted MR images of the prostate

AIM: To evaluate the impact of computed b = 1400 s/mm2(C-b1400) vs measured b = 1400 s/mm2(M-b1400) diffusion-weighted images(DWI) on lesion detection rate, image quality and quality of lesion demarcation using a modern 3T-MR system based on a small-field-of-view sequence(sFOV). METHODS: Thirty patients(PSA: 9.5 ± 8.7 ng/mL; 68 ± 12 years) referred for magnetic resonance imaging(MRI) of the prostate were enrolled in this study. All measurements were performed on a 3T MR system.For DWI, a single-shot EPI diffusion sequence(b = 0, 100, 400, 800 s/mm2) was utilized. C-b1400 was cal-culated voxelwise from the ADC and diffusion images. Additionally, M-b1400 was acquired for evaluation and comparison. Lesion detection rate and maximum lesion diameters were obtained and compared. Image quality and quality of lesion demarcation were rated accord-ing to a 5-point Likert-type scale. Ratios of lesion-to-bladder as well as prostate-to-bladder signal intensity(SI) were calculated to estimate the signal-to-noise-ratio(SNR). RESULTS: Twenty-four lesions were detected on M-b1400 images and compared to C-b1400 images. C-b1400 detected three additional cancer suspicious lesions. Overall image quality was rated significantly better and SI ratios were significantly higher on C-b1400(2.3 ± 0.8 vs 3.1 ± 1.0, P < 0.001; 5.6 ± 1.8 vs 2.8 ± 0.9, P < 0.001). Comparison of lesion size showed no significant differences between C- and M-b1400(P = 0.22). CONCLUSION: Combination of a high b-value extrap-olation and sFOV may contribute to increase diagnostic accuracy of DWI without an increase of acquisition time, which may be useful to guide targeted prostate biopsies and to improve quality of multiparametric MRI(mMRI) especially under economical aspects in a pri-vate practice setting.

Single-centre all-comers registry reveals promising long-term clinical results of the Endeavor^TM-Stent

Background: To evaluate the safety and efficacy of the EndeavorTM-Stent-Stent (Medtronic Corp., USA) in daily practice. Material and methods: Data come from a prospective single-centre registry. Between 2005 and 2007 all patients, who received at least one Endeavor? coronary stent, were included into a registry. Patients were contacted after 12 and 24 - 36 months. Results: 326 patients (97 females, mean age 67.5 ± 10.3 years) were included. From these patients 137 (42%) had a 3-vessel disease, 96 (29%) presented with myocardial infarction ≤ 72 hrs, 19 (6%) with a left ventricular ejection fraction TM-Stent-Stents. Per patient, 0.4 ± 0.7 bare metal stents were implanted. Median follow-up time was 35.3 months, during follow-up 165 patients (50.6%) had repeated angiography. After 12 (24) months overall mortality was 5.8% (7.3%), cardiac mortality 3.1% (3.5%), myocardial infarction rate 1.5% (4.1%), target-vessel revascu-larization rate 8.7% (12.4%), target-lesion revascu-larization rate 6.1% (8.4%), and cumulative MACE-rate 14.1% (21.9%). In total, 2 definite or likely stent-thromboses (0.6%) occurred during follow-up. Logistic regression revealed the treatment of saphenous vein grafts and aorto-coronary ostial lesions as risk factors for target lesion revascularization. Conclusion: The EndeavorTM-Stent-Stent is a safe and effective drug-eluting stent in the treatment of daily-life coronary patients. Treatment of vein grafts and aorto-coronary ostial lesions appear to be associated with a higher need for re-interventions.