ABSTRACT
In this review, the authors summarize the latest imaging methods and recommendations for each of the various steps in managing patients with head and neck cancer, from staging of disease to posttreatment surveillance. Because staging of head and neck cancers is different for various subsites of the head and neck, imaging is discussed separately for each. A separate discussion of imaging of perineural spread, occult primary tumors, and lymph nodes is followed by a discussion of paradigms for surveillance imaging in the posttreatment neck.
Subject(s)
Head and Neck Neoplasms/diagnostic imaging , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/therapy , Humans , Neoplasm Staging , Patient Care Planning , Population SurveillanceABSTRACT
BACKGROUND: Over the last decade there has been escalating concern regarding the increasing radiation exposure stemming from CT exams, particularly in children. Adaptive statistical iterative reconstruction (ASIR) is a relatively new and promising tool to reduce radiation dose while preserving image quality. While encouraging results have been found in adult head and chest and body imaging, validation of this technique in pediatric population is limited. OBJECTIVE: The objective of our study was to retrospectively compare the image quality and radiation dose of pediatric head CT examinations obtained with ASIR compared to pediatric head CT examinations without ASIR in a large patient population. MATERIALS AND METHODS: Retrospective analysis was performed on 82 pediatric head CT examinations. This group included 33 pediatric head CT examinations obtained with ASIR and 49 pediatric head CT examinations without ASIR. Computed tomography dose index (CTDIvol) was recorded on all examinations. Quantitative analysis consisted of standardized measurement of attenuation and the standard deviation at the bilateral centrum semiovale and cerebellar white matter to evaluate objective noise. Qualitative analysis consisted of independent assessment by two radiologists in a blinded manner of gray-white differentiation, sharpness and overall diagnostic quality. RESULTS: The average CTDIvol value of the ASIR group was 21.8 mGy (SD = 4.0) while the average CTDIvol for the non-ASIR group was 29.7 mGy (SD = 13.8), reflecting a statistically significant reduction in CTDIvol in the ASIR group (P < 0.01). There were statistically significant reductions in CTDI for the 3- to 12-year-old ASIR group as compared to the 3- to 12-year-old non-ASIR group (21.5 mGy vs. 30.0 mGy; P = 0.004) as well as statistically significant reductions in CTDI for the >12-year-old ASIR group as compared to the >12-year-old non-ASIR group (29.7 mGy vs. 49.9 mGy; P = 0.0002). Quantitative analysis revealed no significant difference in the homogeneity of variance in the ASIR group compared to the non-ASIR group. Radiologist assessment of gray-white differentiation, sharpness and overall diagnostic quality in ASIR examinations was not substantially different compared to non-ASIR examinations. CONCLUSION: The use of ASIR in pediatric head CT examinations allows for a 28% CTDIvol reduction in the 3- to 12-year-old age group and a 48% reduction in the >12-year-old age group without substantially affecting image quality.
Subject(s)
Brain/diagnostic imaging , Radiation Dosage , Radiographic Image Interpretation, Computer-Assisted/methods , Tomography, X-Ray Computed/methods , Child , Child, Preschool , Female , Humans , Male , Pediatrics/methods , Retrospective StudiesABSTRACT
This article is a review of vascular tumors and malformations that occur in infancy and childhood. It discusses anomalies of arterial, venous, capillary, lymphatic, and mixed vascular endothelium in terms of their varying forms, clinical course, imaging characteristics, complications, and treatment. The comparative utility of various imaging modalities is simplified.
Subject(s)
Head and Neck Neoplasms/blood supply , Head/blood supply , Hemangioma/diagnostic imaging , Neck/blood supply , Vascular Malformations/diagnostic imaging , Child , Diagnostic Imaging , Head/diagnostic imaging , Head and Neck Neoplasms/diagnostic imaging , Hemangioma/complications , Hemangioma/physiopathology , Hemangioma/therapy , Humans , Infant , Neck/diagnostic imaging , Radiography , Treatment Outcome , Vascular Malformations/physiopathology , Vascular Malformations/therapySubject(s)
Dermatology , Patient Compliance , Periodicals as Topic , Psoriasis/drug therapy , Publications , Bibliometrics , HumansABSTRACT
Here we describe the Wake Forest University Pipeline, a fully automated method for the processing of fMRI data using SPM. The method includes fully automated data transfer and archiving from the point of acquisition, real-time batch script generation, distributed grid processing, interface to SPM in MATLAB, error recovery and data provenance, DICOM conversion and PACS insertion. It has been used for automated processing of fMRI experiments, as well as for the clinical implementation of fMRI and spin-tag perfusion imaging. The pipeline requires no manual intervention, and can be extended to any studies requiring offline processing.
