Abstract:
OBJECTIVE:The aim of this study was to optimize computed tomography (CT) surveillance of skeletal metastases in patients with breast cancer through the use of osseous subtraction maps between baseline and follow-up examinations created by a novel software algorithm. The new postprocessing algorithm segments the original bone followed by image intensity-based rigid alignment creating gray-shaded maps that highlight focal or diffuse loss or increase in bone attenuation. MATERIALS AND METHODS:Institutional review board was obtained for this retrospective data evaluation. A total of 33 consecutive patients (31 female; 2 male; mean age, 59.13 ± 12.68 years; range, 32-81 years) with breast cancer were included, who underwent 143 standardized baseline and follow-up CT examinations between February 2014 and June 2016. We classified bone metastases into lytic, sclerotic, and mixed osseous lesions. Any new osteolysis inside a known sclerotic lesion and enlargement of pre-existing sclerotic lesions were considered to represent progressive disease (PD), whereas no change was classified as stable disease (SD). Results were compared additionally with the course of the disease considering the entire skeleton and other involved organs. Software-created automated bone subtraction maps were compared with conventional CT interpretations of axial 5-mm and coronal 1-mm reformatted images. Region of interest measurements were used to quantify new lesions. Results were validated by clinical and CT follow-up. Reading time was evaluated. RESULTS:Skeletal metastases were present in 17/33 (51%) patients (9 sclerotic, 2 lytic, 6 mixed) at baseline. The use of bone subtraction maps resulted in an overall change of response classification into PD in 9/33 (8.1%) patients. Compared with conventional CT evaluation, the bone subtraction maps disclosed 123 new or enlarging sclerotic and 32 new lytic metastases in 23/33 (30.9%) examinations. Mean attenuation of new bone lesions (sclerotic or lytic) significantly increased or decreased (P < 0.01) in all patients. Bone attenuation in pelvic areas without evident metastatic disease significantly increased in patients with PD (P = 0.019), whereas there was no change in SD (P = 0.076). Lesion-based sensitivity, specificity, accuracy, positive predictive values, and negative predictive values were 98.7%, 79.5%, 94.5%, 95.1%, and 94.5%, respectively. Interobserver agreement was good (κ = 0.80; P = 0.077). Reading time was significantly faster for the bone subtraction maps versus 5-mm axial images (P < 0.001). CONCLUSIONS:Longitudinal bone subtraction maps increase the accuracy and efficiency of CT diagnosis of skeletal metastases in patients with breast cancer.
journal_name
Invest Radioljournal_title
Investigative radiologyauthors
Horger M,Thaiss WM,Wiesinger B,Ditt H,Fritz J,Nikolaou K,Kloth Cdoi
10.1097/RLI.0000000000000343subject
Has Abstractpub_date
2017-02-01 00:00:00pages
288-294issue
2eissn
0020-9996issn
1536-0210journal_volume
52pub_type
杂志文章abstract:PURPOSE:To evaluate the dependency of tumor contrast enhancement (CE) in regard to protein-binding properties of contrast agents, using 4 different agents with a wide range of protein-binding capacities in a standardized rat brain glioma model. MATERIAL AND METHODS:Sixteen rats with implanted brain gliomas were evalua...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/RLI.0b013e318191a334
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abstract::Thoracic metastases from squamous carcinoma and adenocarcinoma of the cervix were studied by reviewing 245 consecutive cases to describe comparative incidence, natural history, and radiographic patterns. The incidence of chest metastases was higher for adenocarcinoma (20%) than for squamous carcinoma (4%). Few patient...
journal_title:Investigative radiology
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doi:10.1097/00004424-198003000-00004
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abstract::Dense cavitary "photopenia" was observed on 21 of 200 consecutive stress perfusion scintigrams. A prominent finding in many cases, it sometimes occupied only a portion of the region overlying the ventricular cavity, was often seen in some projections and not others, and was frequently adjacent to myocardial perfusion ...
journal_title:Investigative radiology
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doi:10.1097/00004424-198507000-00009
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abstract:RATIONALE AND OBJECTIVES:The basic characteristics of BR1, a novel echo contrast agent based on stabilized sulfur hexafluoride (SF6) microbubbles have been evaluated. METHODS:The authors determined the physicochemical properties (bubble concentration, bubble size distribution, resistance to pressure, and stability) an...
journal_title:Investigative radiology
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doi:10.1097/00004424-199508000-00001
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of nephrogenic systemic fibrosis (NSF) in patients with chronic kidney disease (CKD) who have received gadopentetate dimeglumine. MATERIALS AND METHODS:We retrospectively studied all patients who underwent contrast-enhanced magnetic resonance imagings (CE-MRIs) between January 1, ...
journal_title:Investigative radiology
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journal_title:Investigative radiology
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abstract:RATIONALE AND OBJECTIVES:Very small dextran-coated magnetite particles were developed. These particles can be used either as immunospecific contrast agents for MRI by coupling to antibodies or as an interstitial contrast agent. METHODS:The particles were synthesized from iron chloride/dextran solutions. Size was evalu...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-200009000-00006
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abstract:RATIONALE AND OBJECTIVES:High signal intensity in the basal ganglia on T1-weighted MR imaging has been reported in chronic manganese (Mn) poisoning. However, the exact meaning of the high signal intensity remains unclear: does it result from Mn itself, secondary pathologic changes of the brain tissue, or both? The goal...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-199906000-00001
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journal_title:Investigative radiology
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journal_title:Investigative radiology
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-198904000-00008
更新日期:1989-04-01 00:00:00
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journal_title:Investigative radiology
pub_type: 临床试验,杂志文章
doi:10.1097/00004424-200106000-00002
更新日期:2001-06-01 00:00:00
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/RLI.0000000000000030
更新日期:2014-06-01 00:00:00
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journal_title:Investigative radiology
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doi:10.1097/RLI.0b013e318164b71d
更新日期:2008-05-01 00:00:00
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-199401000-00012
更新日期:1994-01-01 00:00:00
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journal_title:Investigative radiology
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doi:
更新日期:2005-01-01 00:00:00
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-199708000-00001
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abstract::Altered concentrations of brain beta endorphin and spinal cord encephalin have been reported in mice with iatrogenic arachnoiditis. We measured beta-endorphin concentration in cerebrospinal fluid (CSF) in normal monkeys and in monkeys with various degrees of arachnoiditis resulting from myelography and spinal surgery ...
journal_title:Investigative radiology
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doi:10.1097/00004424-198803000-00006
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-200206000-00005
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journal_title:Investigative radiology
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journal_title:Investigative radiology
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journal_title:Investigative radiology
pub_type: 杂志文章,多中心研究
doi:10.1097/RLI.0b013e3181caea5b
更新日期:2010-03-01 00:00:00
abstract::High-resolution real-time ultrasonography (5, 7.5, and 10 MHz) was used to examine the menisci of the knee in ten normal volunteers and in ten patients with knee injuries. The posterior horns of the medial and lateral menisci were easily demonstrated. Normal anatomy and pathologic changes could be imaged in the menisc...
journal_title:Investigative radiology
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doi:10.1097/00004424-198604000-00008
更新日期:1986-04-01 00:00:00
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/01.rli.0000129154.50654.4e
更新日期:2004-08-01 00:00:00
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/RLI.0000000000000223
更新日期:2016-03-01 00:00:00
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journal_title:Investigative radiology
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doi:10.1097/00004424-199010000-00007
更新日期:1990-10-01 00:00:00
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journal_title:Investigative radiology
pub_type: 杂志文章
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更新日期:2014-06-01 00:00:00
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-197801000-00014
更新日期:1978-01-01 00:00:00
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journal_title:Investigative radiology
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更新日期:2010-12-01 00:00:00