The Role of Whole-Body Magnetic Resonance Imaging in Assessing Extrapulmonary Metastases in Osteosarcoma Staging and Restaging: A Pilot Study.

OBJECTIVE: The aim of the study is to investigate the role of whole-body magnetic resonance imaging (MRI) in assessing extrapulmonary metastases in primary osteosarcoma staging. METHODS: We retrospectively reviewed medical data to identify primary osteosarcoma patients with available preoperative whole-body MRI obtained in the staging or restaging. Histopathology was the reference test for assessing the diagnostic performance, if available. Otherwise, oncology board decisions were used as the reference. In addition, the benefits of whole-body MRI to F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) and bone scintigraphy were investigated. RESULTS: In all, 36 patients with osteosarcoma (24 staging, 12 restaging) with a mean age of 16.36 ± 5.63 years (range, 9-29 years) were included in the study. The median follow-up duration was 26.61 months (interquartile range, 33.3 months). Of 36 patients, 8 had skeletal, 1 had a lymph node, and 1 had a subcutaneous metastasis. Whole-body MRI correctly identified all patients with metastatic disease but incorrectly classified a bone infarct in one patient as a skeletal metastasis, equating a scan-level sensitivity, specificity, accuracy, negative predictive value, and positive predictive value of 100%, 96.3%, 97.3%, 100%, and 90.91%. Whole-body MRI contributed to bone scintigraphy by identifying a skeletal metastasis in one patient and positron emission tomography-computed tomography by ruling out a skeletal metastasis in another. CONCLUSIONS: Whole-body MRI could accurately identify extrapulmonary metastases in primary osteosarcoma patients for staging or restaging. In addition, it might contribute to the standard whole-body imaging methods.

Using MRI to assess aortic wall thickness in the multiethnic study of atherosclerosis: distribution by race, sex, and age.

OBJECTIVE: Understanding the determinants of subclinical atherosclerosis may aid in elucidating the pathogenesis of atherosclerosis and guide prevention strategies. In this pilot study, we investigated the role of aortic wall thickness as a measure of subclinical atherosclerosis, assessed a method by which to measure aortic wall thickness using MRI, and attempted to define differences in aortic wall thickness by patient race, sex, and age. SUBJECTS AND METHODS. In this prospective study, 196 participants (99 black, 97 white; 98 men, 98 women) were selected from the Multiethnic Study of Atherosclerosis, which consists of participants 45-84 years old without clinical cardiovascular disease, who were recruited from six study centers in the United States. We performed fast spin-echo double inversion recovery MRI to measure thoracic aortic wall thickness. We tested interobserver agreement using the intraclass correlation coefficient, for sex and race differences in wall thickness using the Mann-Whitney test, and for associations between age and wall thickness using linear regression. RESULTS: Reproducibility was excellent for measurements of average and maximal wall thickness on MRI. Average and maximal wall thickness increased with age (p < 0.001 and p = 0.002, respectively). Men had greater mean average wall thickness (2.32 vs 2.11 mm, p = 0.028) and mean maximal wall thickness (3.85 vs 3.31 mm, p = 0.010) than women. Blacks had greater mean maximal wall thickness than whites (3.74 vs 3.42 mm, p = 0.023). CONCLUSION: MRI is a feasible method to measure aortic wall thickness with high interobserver agreement. Aortic wall thickness increases with age and also varies by race and sex.

Cyclic sciatica caused by infiltrative endometriosis: MRI findings.

Endometriosis, an important gynecological disorder of reproductive women, affects most commonly the ovaries and less frequently the gastrointestinal tract, chest, urinary tract, and soft tissues. Endometriosis classically appears on MRI as a mass with a large cystic component and variable signal intensities on T1- and T2-weighted images due to the presence of variable degradation of hemorrhagic products. Endometriosis in an atypical location, an infiltrative appearance and without cystic-hemorrhagic components has rarely been described. We report on a 33-year-old woman with cyclic sciatica due to histologically documented infiltrative endometriosis involving the area of the left sciatic notch.

Pseudomass of the sternal manubrium in osteogenesis imperfecta.

Skeletal abnormalities such as hypertrophic callus formation and "popcorn" calcifications are rare radiological findings of osteogenesis imperfecta, causing tumor-like appearances on imaging. We report on a 7-year-old girl with osteogenesis imperfecta presenting with hepatomegaly and palpable lymphadenopathy in the left inguinal region on physical examination. Computed tomography examination revealed a high-density mass-like lesion of the manubrium sterni. Ultrasonography and a lateral roentgenogram of the chest verified that this was a pseudomass caused by a bowed sternal manubrium.

Carcinoma of esophagus: radiologic diagnosis and staging.

Esophageal carcinoma is an uncommon malignancy accounting for approximately 7% of gastrointestinal tract cancers and 1% of all cancers. Esophageal cancer still remains one of the most lethal of all cancers. Since a multimodality approach is presently used to treat esophageal cancer, early radiologic diagnosis and accurate tumor staging are essential to direct therapy toward cure or palliation. This article presents a review of radiologic diagnosis and staging of esophageal cancer.