Objective： To prospectively compare the discriminative capacity of dynamic contrast enhanced-magnetic resonance imaging（DCE-MRI） with that of^18F-fluorodeoxyglucose（^18F-FDG） positron emission tomography/computed...Objective： To prospectively compare the discriminative capacity of dynamic contrast enhanced-magnetic resonance imaging（DCE-MRI） with that of^18F-fluorodeoxyglucose（^18F-FDG） positron emission tomography/computed tomography（PET/CT） in the differentiation of malignant and benign solitary pulmonary nodules（SPNs）.Methods： Forty-nine patients with SPNs were included in this prospective study. Thirty-two of the patients had malignant SPNs, while the other 17 had benign SPNs. All these patients underwent DCE-MRI and ^18F-FDG PET/CT examinations. The quantitative MRI pharmacokinetic parameters, including the trans-endothelial transfer constant（K^trans）, redistribution rate constant（Kep）, and fractional volume（Ve）, were calculated using the Extended-Tofts Linear two-compartment model. The ^18F-FDG PET/CT parameter, maximum standardized uptake value（SUV（max））, was also measured. Spearman＇s correlations were calculated between the MRI pharmacokinetic parameters and the SUV（max） of each SPN. These parameters were statistically compared between the malignant and benign nodules. Receiver operating characteristic（ROC） analyses were used to compare the diagnostic capability between the DCE-MRI and ^18F-FDG PET/CT indexes.Results： Positive correlations were found between K^trans and SUV（max）, and between K（ep） and SUV（max）（P〈0.05）.There were significant differences between the malignant and benign nodules in terms of the K^trans, K（ep） and SUV（max） values（P〈0.05）. The areas under the ROC curve（AUC） of K^trans） K（ep） and SUV（max） between the malignant and benign nodules were 0.909, 0.838 and 0.759, respectively. The sensitivity and specificity in differentiating malignant from benign SPNs were 90.6% and 82.4% for K^trans; 87.5% and 76.5% for K（ep）; and 75.0% and 70.6%for SUV（max）, respectively. The sensitivity and specificity of K^trans and K（ep） were higher than those of SUV（max）, but there was no significant difference between them（P〉0.05）.Conclusions： DCE-MRI can be used to differentiate between benign and malignant SPNs and has the advantage of being radiation free.展开更多
Objective: To evaluate the efficacy, feasibility and safety of contrast-enhanced CT-guided core biopsy of retroperitoneal masses. Materials and Methods: Contrast-enhanced CT-guided biopsy of retroperitoneal masses was...Objective: To evaluate the efficacy, feasibility and safety of contrast-enhanced CT-guided core biopsy of retroperitoneal masses. Materials and Methods: Contrast-enhanced CT-guided biopsy of retroperitoneal masses was performed in 26 patients. Histopathological diagnosis was obtained and accuracy was calculated. Two blinded radiologists determined feasibility of biopsy procedures on routine CT-guidance, and compared accessibility of target lesions using contrast-enhanced and non-contrast-enhanced CT. Results: Satisfactory samples were obtained in all 26 patients and pathological diagnosis was made in 24. Accuracy was 95.5%. Routine CT-guided biopsy punctures were not satisfaction in 4/26 patients, and contrast-enhanced CT scans rendered the target lesions more accessible in 16 patients. Conclusion: Contrast-enhanced CT-guided biopsy increases the feasibility of biopsy of retroperitoneal masses.展开更多
Purpose: The purpose of this study was to retrospectively assess the detectability and enhancement pattern of rectal carcinoid tumors on contrast-enhanced computed tomography colonography (CE-CTC). Methods: The study ...Purpose: The purpose of this study was to retrospectively assess the detectability and enhancement pattern of rectal carcinoid tumors on contrast-enhanced computed tomography colonography (CE-CTC). Methods: The study sample consisted of 12 lesions in nine patients of rectal carcinoid tumors. To evaluate the detectability, two radiologists reviewed axial and 3D images including air enema (AE), virtual endoscopy (VE), and virtual colon dissection (VCD). To determine the contrast enhancement pattern of the tumors, the CT attenuation value of each lesion was measured in three phases. Results: Four of the 12 lesions (33%) were detected on axial images in patients in both the prone and supine positions, the sizes of which were 6 mm or larger. Seven lesions (58%), including the four lesions mentioned above, were detected on 3D images including AE and VE in patients in the prone position, the sizes of which were 5 mm or larger. The ranges of CT attenuation values of the lesions at 40 s, 70 s and 240 s were 112 - 147, 116 - 140 and 82 - 97 HU, respectively. Conclusion: Rectal carcinoid tumors are challenging to detect on CE-CTC. They demonstrated enhancement at the early phase and washout at the delayed phase on CE-CTC.展开更多
Objectives: This study aimed to determine whether errors in vascular measurements would affect device selection in endovascular aortic repair (EVAR) by comparing measurements obtained using non-contrast computed tomog...Objectives: This study aimed to determine whether errors in vascular measurements would affect device selection in endovascular aortic repair (EVAR) by comparing measurements obtained using non-contrast computed tomography (NCT) with those obtained using contrast-enhanced CT (CECT). Materials and Methods: This single-center, retrospective study included 25 patients who underwent EVAR for abdominal aortic aneurysm at our institution. A 1-mm horizontal cross-sectional slice of NCT and CECT from each patient was retrospectively reviewed. The area from the abdominal aorta to the common iliac artery was divided into four zones. A centerline was created using the NCT by manually plotting the center points. Subsequently, the centerlines were automatically extracted and manually corrected during the arterial phase of CECT. The diameter and length of each zone were measured for each modality. The mean diameters and lengths of the target vessels were compared between NCT and CECT. Results: The measurements obtained using both methods were reproducible and demonstrated good agreement. The mean differences in vessel length and diameter measurements for each segment between NCT and CECT were not statistically significant, indicating good consistency. Conclusion: NCT may be useful for preoperative EVAR evaluation in patients with renal dysfunction or allergies to contrast agents.展开更多
Purpose: Compared the performance of contrast-enhanced PET/CT and non-enhanced PET/CT for preoperatively detecting pelvic and para-aortic lymph node metastases in patients with cervical cancer. Methods: This prospecti...Purpose: Compared the performance of contrast-enhanced PET/CT and non-enhanced PET/CT for preoperatively detecting pelvic and para-aortic lymph node metastases in patients with cervical cancer. Methods: This prospective study included 72 patients with clinically M0 cervical cancer. They underwent surgery within two weeks of PET/CT imaging. Imaging consisted of a whole-body PET/CT protocol without intravenous contrast, followed by abdominal and pelvic PET/CT protocol including contrast-enhanced CT. We compared the diagnostic efficiency between the methods on per-patient and per-lesion basis. Results: Patient-based analysis showed that the sensitivity, specificity, and accuracy of contrast-enhanced PET/CT were 63.6% (14/22), 94.0% (47/50), and 84.7%(61/72), respectively, whereas those of non-enhanced PET/CT were 54.5% (12/22), 88.0% (44/50), and 77.8% (56/72), respectively, and those of enhanced CT alone were 36.4% (8/22), 80.0% (40/50), and 66.7% (48/72), respectively. Lesion-based analysis showed that the sensitivity, specificity, and accuracy of contrast-enhanced PET/CT were 77.7% (87/112), 98.7%(938/950), and 96.5% (1025/1062), respectively, whereas those of non-enhanced PET/CT were 69.6% (78/112), 97.5% (926/950), and 94.5% (1004/1062), respectively, and those of enhanced CT were 54.4% (61/112), 96.1% (913/950), and 91.7% (974/1062), respectively. Contrast-enhanced PET/CT had the best sensitivity, specificity and accuracy. Although patient-based analysis showed no significant difference between contrast-enhanced PET/CT and non-enhanced PET/CT (p =0.540, 0.295 and 0.286), the specificity and accuracy of these two methods were significantly different on lesion-based analysis (p =0.043 and 0.027).展开更多
Purpose: This study was undertaken to determine if portal-inflow bolus tracking outperforms aortic bolus tracking with respect to the image quality of contrast-enhanced portal venous-phase CT of the liver in patients ...Purpose: This study was undertaken to determine if portal-inflow bolus tracking outperforms aortic bolus tracking with respect to the image quality of contrast-enhanced portal venous-phase CT of the liver in patients without chronic liver damage. Materials and Methods: Contrast-enhanced CT of the liver was performed in 132 consecutive patients without chronic liver damage. Patients were prospectively assigned to three protocols: Protocol A—a portal venous-phase scan delay of 6 seconds after superior mesenteric venous (SMV) enhancement increased by 70 HU or 14 seconds after SMV enhancement was visually confirmed, and Protocols B and C—40 and 50 seconds, respectively, after abdominal aortic enhancement increased by 100 HU. Enhancement (ΔHU) of abdominal aorta, portal trunk, and liver parenchyma and diagnostic acceptability were assessed. Results: ΔHU of aorta was higher for protocol A than for protocols B and C (P P Conclusion: Portal-inflow bolus tracking did not outperform aortic tracking in terms of optimization of portal venous-phase CT in patients without chronic liver damage.展开更多
To assess the correlation of renal volume measured on CT with aortic contrast enhancement on the hepatic arterial phase of dynamic CT, 64 consecutive patients (34 men, 30 women) were retrospectively examined. Renal vo...To assess the correlation of renal volume measured on CT with aortic contrast enhancement on the hepatic arterial phase of dynamic CT, 64 consecutive patients (34 men, 30 women) were retrospectively examined. Renal volumes were measured on CT. The aortic contrast enhancement was inversely correlated with renal medullary volume (r = -0.52, p 0.0001), and renal cortical volume (r = -0.3, p = 0.02). Renal volume may have inverse correlation with aortic contrast enhancement on the hepatic arterial phase of dynamic CT. This might call for adjustment of contrast material dose based in part on renal volume in the future.展开更多
基金supported by the Jiangsu Province Natural Science Foundation (No. BK20161291)the Nantong Science Foundation of China (No. MS2201507)the Nantong Municipal Commission of Health and Family Planning Young Fund (No. WQ2014047)
文摘Objective： To prospectively compare the discriminative capacity of dynamic contrast enhanced-magnetic resonance imaging（DCE-MRI） with that of^18F-fluorodeoxyglucose（^18F-FDG） positron emission tomography/computed tomography（PET/CT） in the differentiation of malignant and benign solitary pulmonary nodules（SPNs）.Methods： Forty-nine patients with SPNs were included in this prospective study. Thirty-two of the patients had malignant SPNs, while the other 17 had benign SPNs. All these patients underwent DCE-MRI and ^18F-FDG PET/CT examinations. The quantitative MRI pharmacokinetic parameters, including the trans-endothelial transfer constant（K^trans）, redistribution rate constant（Kep）, and fractional volume（Ve）, were calculated using the Extended-Tofts Linear two-compartment model. The ^18F-FDG PET/CT parameter, maximum standardized uptake value（SUV（max））, was also measured. Spearman＇s correlations were calculated between the MRI pharmacokinetic parameters and the SUV（max） of each SPN. These parameters were statistically compared between the malignant and benign nodules. Receiver operating characteristic（ROC） analyses were used to compare the diagnostic capability between the DCE-MRI and ^18F-FDG PET/CT indexes.Results： Positive correlations were found between K^trans and SUV（max）, and between K（ep） and SUV（max）（P〈0.05）.There were significant differences between the malignant and benign nodules in terms of the K^trans, K（ep） and SUV（max） values（P〈0.05）. The areas under the ROC curve（AUC） of K^trans） K（ep） and SUV（max） between the malignant and benign nodules were 0.909, 0.838 and 0.759, respectively. The sensitivity and specificity in differentiating malignant from benign SPNs were 90.6% and 82.4% for K^trans; 87.5% and 76.5% for K（ep）; and 75.0% and 70.6%for SUV（max）, respectively. The sensitivity and specificity of K^trans and K（ep） were higher than those of SUV（max）, but there was no significant difference between them（P〉0.05）.Conclusions： DCE-MRI can be used to differentiate between benign and malignant SPNs and has the advantage of being radiation free.
文摘Objective: To evaluate the efficacy, feasibility and safety of contrast-enhanced CT-guided core biopsy of retroperitoneal masses. Materials and Methods: Contrast-enhanced CT-guided biopsy of retroperitoneal masses was performed in 26 patients. Histopathological diagnosis was obtained and accuracy was calculated. Two blinded radiologists determined feasibility of biopsy procedures on routine CT-guidance, and compared accessibility of target lesions using contrast-enhanced and non-contrast-enhanced CT. Results: Satisfactory samples were obtained in all 26 patients and pathological diagnosis was made in 24. Accuracy was 95.5%. Routine CT-guided biopsy punctures were not satisfaction in 4/26 patients, and contrast-enhanced CT scans rendered the target lesions more accessible in 16 patients. Conclusion: Contrast-enhanced CT-guided biopsy increases the feasibility of biopsy of retroperitoneal masses.
文摘Purpose: The purpose of this study was to retrospectively assess the detectability and enhancement pattern of rectal carcinoid tumors on contrast-enhanced computed tomography colonography (CE-CTC). Methods: The study sample consisted of 12 lesions in nine patients of rectal carcinoid tumors. To evaluate the detectability, two radiologists reviewed axial and 3D images including air enema (AE), virtual endoscopy (VE), and virtual colon dissection (VCD). To determine the contrast enhancement pattern of the tumors, the CT attenuation value of each lesion was measured in three phases. Results: Four of the 12 lesions (33%) were detected on axial images in patients in both the prone and supine positions, the sizes of which were 6 mm or larger. Seven lesions (58%), including the four lesions mentioned above, were detected on 3D images including AE and VE in patients in the prone position, the sizes of which were 5 mm or larger. The ranges of CT attenuation values of the lesions at 40 s, 70 s and 240 s were 112 - 147, 116 - 140 and 82 - 97 HU, respectively. Conclusion: Rectal carcinoid tumors are challenging to detect on CE-CTC. They demonstrated enhancement at the early phase and washout at the delayed phase on CE-CTC.
文摘Objectives: This study aimed to determine whether errors in vascular measurements would affect device selection in endovascular aortic repair (EVAR) by comparing measurements obtained using non-contrast computed tomography (NCT) with those obtained using contrast-enhanced CT (CECT). Materials and Methods: This single-center, retrospective study included 25 patients who underwent EVAR for abdominal aortic aneurysm at our institution. A 1-mm horizontal cross-sectional slice of NCT and CECT from each patient was retrospectively reviewed. The area from the abdominal aorta to the common iliac artery was divided into four zones. A centerline was created using the NCT by manually plotting the center points. Subsequently, the centerlines were automatically extracted and manually corrected during the arterial phase of CECT. The diameter and length of each zone were measured for each modality. The mean diameters and lengths of the target vessels were compared between NCT and CECT. Results: The measurements obtained using both methods were reproducible and demonstrated good agreement. The mean differences in vessel length and diameter measurements for each segment between NCT and CECT were not statistically significant, indicating good consistency. Conclusion: NCT may be useful for preoperative EVAR evaluation in patients with renal dysfunction or allergies to contrast agents.
文摘Purpose: Compared the performance of contrast-enhanced PET/CT and non-enhanced PET/CT for preoperatively detecting pelvic and para-aortic lymph node metastases in patients with cervical cancer. Methods: This prospective study included 72 patients with clinically M0 cervical cancer. They underwent surgery within two weeks of PET/CT imaging. Imaging consisted of a whole-body PET/CT protocol without intravenous contrast, followed by abdominal and pelvic PET/CT protocol including contrast-enhanced CT. We compared the diagnostic efficiency between the methods on per-patient and per-lesion basis. Results: Patient-based analysis showed that the sensitivity, specificity, and accuracy of contrast-enhanced PET/CT were 63.6% (14/22), 94.0% (47/50), and 84.7%(61/72), respectively, whereas those of non-enhanced PET/CT were 54.5% (12/22), 88.0% (44/50), and 77.8% (56/72), respectively, and those of enhanced CT alone were 36.4% (8/22), 80.0% (40/50), and 66.7% (48/72), respectively. Lesion-based analysis showed that the sensitivity, specificity, and accuracy of contrast-enhanced PET/CT were 77.7% (87/112), 98.7%(938/950), and 96.5% (1025/1062), respectively, whereas those of non-enhanced PET/CT were 69.6% (78/112), 97.5% (926/950), and 94.5% (1004/1062), respectively, and those of enhanced CT were 54.4% (61/112), 96.1% (913/950), and 91.7% (974/1062), respectively. Contrast-enhanced PET/CT had the best sensitivity, specificity and accuracy. Although patient-based analysis showed no significant difference between contrast-enhanced PET/CT and non-enhanced PET/CT (p =0.540, 0.295 and 0.286), the specificity and accuracy of these two methods were significantly different on lesion-based analysis (p =0.043 and 0.027).
文摘Purpose: This study was undertaken to determine if portal-inflow bolus tracking outperforms aortic bolus tracking with respect to the image quality of contrast-enhanced portal venous-phase CT of the liver in patients without chronic liver damage. Materials and Methods: Contrast-enhanced CT of the liver was performed in 132 consecutive patients without chronic liver damage. Patients were prospectively assigned to three protocols: Protocol A—a portal venous-phase scan delay of 6 seconds after superior mesenteric venous (SMV) enhancement increased by 70 HU or 14 seconds after SMV enhancement was visually confirmed, and Protocols B and C—40 and 50 seconds, respectively, after abdominal aortic enhancement increased by 100 HU. Enhancement (ΔHU) of abdominal aorta, portal trunk, and liver parenchyma and diagnostic acceptability were assessed. Results: ΔHU of aorta was higher for protocol A than for protocols B and C (P P Conclusion: Portal-inflow bolus tracking did not outperform aortic tracking in terms of optimization of portal venous-phase CT in patients without chronic liver damage.
文摘To assess the correlation of renal volume measured on CT with aortic contrast enhancement on the hepatic arterial phase of dynamic CT, 64 consecutive patients (34 men, 30 women) were retrospectively examined. Renal volumes were measured on CT. The aortic contrast enhancement was inversely correlated with renal medullary volume (r = -0.52, p 0.0001), and renal cortical volume (r = -0.3, p = 0.02). Renal volume may have inverse correlation with aortic contrast enhancement on the hepatic arterial phase of dynamic CT. This might call for adjustment of contrast material dose based in part on renal volume in the future.
