ABSTRACT
Magnetic resonance imaging (MRI) is of exceptional importance in the diagnostics and monitoring of multiple sclerosis (MS); however, a close interdisciplinary cooperation between neurologists in private practice, (neuro)radiological practices, hospitals or specialized MS centers is only rarely established. In particular, there is a lack of standardized MRI protocols for image acquisition as well as established quality parameters, which guarantee the comparability of MRI records; however, this is a fundamental prerequisite for an effective application of MRI in the treatment of MS patients, e.g., for making the diagnosis or treatment monitoring. To address these challenges a group of neurologists and (neuro)radiologists developed a consensus proposal for standardization of image acquisition, interpretation and transmission of results and for improvement in interdisciplinary cooperation. This pilot project in the metropolitan area of Essen used a modified Delphi process and was based on the most up to date scientific knowledge. The recommendation takes the medical, economic, temporal and practical aspects of MRI in MS into consideration. The model of interdisciplinary cooperation between radiologists and neurologists with the aim of a regional standardization of MRI could serve as an example for other regions of Germany in order to optimize MRI for MS.
Subject(s)
Multiple Sclerosis , Humans , Multiple Sclerosis/diagnosis , Consensus , Pilot Projects , Magnetic Resonance Imaging/methods , NeurologistsABSTRACT
AIMS: To assess the utility of dynamic contrast-enhanced MRI parameters in the demonstration of early antiangiogenic effects and as prognostic biomarkers in second-line treatment of advanced-stage non-small-cell lung cancer with vatalanib. PATIENTS & METHODS: The transfer constant (K(trans)) and the initial area under the contrast concentration-time curve at 60 s (AUC60) were assessed in 46 patients. Changes were compared with response evaluation from computed tomography imaging and Response Evaluation Criteria In Solid Tumors guidelines. RESULTS: Statistically significant mean reductions in K(trans) (38.4%; p < 0.0001) and AUC60 (24.9%; p < 0.0001) were found at day 2. After 12 weeks, 16 patients (35%) demonstrated stable disease and 30 (65%) demonstrated progressive disease. No statistically significant differences in day 2 K(trans) and AUC60 reductions between stable disease and progressive disease patients were found. CONCLUSION: Dynamic contrast-enhanced MRI can demonstrate a statistically significant reduction in vascular parameters of non-small-cell lung cancer, but does not predict patient outcome.
Subject(s)
Angiogenesis Inhibitors/administration & dosage , Biomarkers , Carcinoma, Non-Small-Cell Lung/drug therapy , Magnetic Resonance Imaging , Phthalazines/administration & dosage , Pyridines/administration & dosage , Aged , Carcinoma, Non-Small-Cell Lung/diagnostic imaging , Carcinoma, Non-Small-Cell Lung/pathology , Clinical Trials as Topic , Contrast Media/administration & dosage , Contrast Media/therapeutic use , Drug Evaluation , Drug-Related Side Effects and Adverse Reactions/pathology , Female , Humans , Male , Middle Aged , Neoplasm Staging , Phthalazines/adverse effects , Pyridines/adverse effects , RadiographyABSTRACT
OBJECTIVES: The combination of parallel acquisition (generalized autocalibrating partially parallel acquisitions) and time-resolved three-dimensional (3D) view-sharing techniques is a promising tool for dynamic contrast-enhanced 3D-magnetic resonance angiography (MRA). We evaluated the influence of different k-space acquisition strategies on image quality for a recently developed time-resolved echo-shared angiographic technique during a contrast-enhanced 3D-MRA of the thoracic vessels. MATERIALS AND METHODS: In 20 patients (16 men, 4 women; range, 28-75 years), 2 dynamic MRA protocols with different k-space acquisition strategies were performed on a 1.5-T whole-body scanner (MAGNETOM Avanto, Siemens AG, Erlangen, Germany) during injection of 5 mL (flow-rate, 3 mL/s) gadobutrol. For protocol 1, the central-region which was updated with every cycle included 20% of the entire k-space (protocol 2: 10%), the peripheral-region was undersampled by a factor of 10 (protocol 2: 5%). Image quality and details were compared visually. Signal-to-noise ratio and sharpness of vessel borders were estimated. RESULTS: Morphologic and functional assessment of the pulmonary arteries and the aorta was significantly improved for protocol 1. The sharpness of vessel borders (3.3 mm vs. 4.1 mm; P = 0.001), image quality, and the visibility of image details were significantly improved for protocol 1 compared with protocol 2. CONCLUSION: The size of the central region that is updated for every frame seems to be more crucial for image quality of echo-shared angiographic techniques than the sampling density in the periphery of the k-space.
