bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantification of left ventricular internal flow from cardiac magnetic resonance images in patients with dyssynchronous heart failure
Authors: Fornwalt Brandon K. , Gonzales Patrick C. , Delfino Jana G. , Eisner Robert , León Angel R. , Oshinski John N.
Published: July 2008

Purpose

To develop a method for quantifying left ventricular (LV) internal flow as a measure of dyssynchrony using standard cine cardiac magnetic resonance (CMR) images.

Materials and Methods

CMR images were obtained from 10 healthy controls and 10 patients with dyssynchronous heart failure (class III/IV, LV ejection fraction <35%, pattern seen in an electrocardiogram QRS duration > 150 msec). The LV volume was reconstructed and divided into 16 regions. Internal flow was defined as the sum of the regional volume changes minus the global volume change during each time step in the cardiac cycle. Internal flow fraction (IFF) was defined as the total internal flow as a percentage of stroke volume during systole (IFFsystole), diastole (IFFdiastole), or the whole cycle (IFFwhole).

Results

IFFwhole was significantly increased in the patients (9.9 ± 5.0% vs. 1.5 ± 0.5% in the controls, P < 0.001). An IFFwhole threshold of 4% discriminated between patients and controls with 90% sensitivity and 100% specificity. IFFdiastole (2.3 ± 0.8%) was greater than IFFsystole (0.8 ± 0.5%) in the normal controls (P < 0.001) while the patients had similar IFFdiastole (7.8 ± 4.2%) and IFFsystole (12.0 ± 7.8%).

Conclusion

Left ventricular internal flow fraction can be quantified from standard CMR images. In this preliminary study, Left ventricular internal flow fraction discriminated patients with dyssynchronous heart failure from normal controls with 95% accuracy. J. Magn. Reson. Imaging 2008;28:375–381. © 2008 Wiley‐Liss, Inc.
Quantifying cerebral changes in adolescence with MRI and deformation based morphometry
Authors: Riddle William R. , DonLevy Susan C. , Wushensky Curtis A. , Dawant Benoit M. , Fitzpatrick J. Michael , Price Ronald R.
Published: July 2008

Purpose

To identify and quantify structural changes in the maturing brain between childhood and adolescence.

Materials and Methods

Two three‐dimensional T1‐weighted MR volumes of the brain were acquired from eight subjects, 6 to 7 years apart. The subjects were 9 to 12 years old on the first scan and 15 to 19 years old on the second scan. The MR scans were converted to one millimeter isotropic volumes, globally aligned with a rigid transform, inhomogeneity corrected, and nonrigid deformation fields between the aligned volumes were calculated. Masks for brain regions were automatically warped with the deformation fields and volumes of brain regions calculated. Color overlays based on the nonrigid deformation fields were generated to identify local volume changes.

Results

Gray matter decreased as much as 60% and white matter increased as much as 250%. The biggest gray matter changes were in the head of the caudates, areas of the putamens, and areas of the thalamus. Some of the biggest white matter changes were in the forceps minor, forceps major, and internal capsule.

Conclusion

Deformation based morphometry with serial scans provides a method to study regional structural changes with brain growth and maturation. J. Magn. Reson. Imaging 2008;28:320–326. © 2008 Wiley‐Liss, Inc.
Automatic image‐driven segmentation of the ventricles in cardiac cine MRI
Authors: Cocosco Chris A. , Niessen Wiro J. , Netsch Thomas , Vonken Evert‐jan P.A. , Lund Gunnar , Stork Alexander , Viergever Max A.
Published: July 2008

Purpose

To propose and to evaluate a novel method for the automatic segmentation of the heart's two ventricles from dynamic (“cine”) short‐axis “steady state free precession” (SSFP) MR images. This segmentation task is of significant clinical importance. Previously published automated methods have various disadvantages for routine clinical use.

Materials and Methods

The proposed method is primarily image‐driven: it exploits the spatiotemporal information provided by modern 3D+time SSFP cardiac MRI, and makes only few and plausible assumptions about the image acquisition and about the imaged heart. Specifically, the method does not require previously trained statistical shape models or gray‐level appearance models, as often used by other methods.

Results

The performance of the segmentation method was demonstrated through a qualitative visual validation on 32 clinical exams: no gross failures for the left‐ventricle (right‐ventricle) on 31 (29) of the exams were found. A validation of resulting quantitative cardiac functional parameters showed good agreement with a manual quantification of 19 clinical exams.

Conclusion

The proposed method is feasible, fast, and robust against anatomical variability and image contrast variations. J. Magn. Reson. Imaging 2008;28:366–374. © 2008 Wiley‐Liss, Inc.
Identification of different heart tissues from MRI C‐SENC images using an unsupervised multi‐stage fuzzy clustering technique
Authors: Ibrahim El‐Sayed H. , Weiss Robert G. , Stuber Matthias , Spooner Amy E. , Osman Nael F.
Published: July 2008

Purpose

To objectively characterize different heart tissues from functional and viability images provided by composite‐strain‐encoding (C‐SENC) MRI.

Materials and Methods

C‐SENC is a new MRI technique for simultaneously acquiring cardiac functional and viability images. In this work, an unsupervised multi‐stage fuzzy clustering method is proposed to identify different heart tissues in the C‐SENC images. The method is based on sequential application of the fuzzy c‐means (FCM) and iterative self‐organizing data (ISODATA) clustering algorithms. The proposed method is tested on simulated heart images and on images from nine patients with and without myocardial infarction (MI). The resulting clustered images are compared with MRI delayed‐enhancement (DE) viability images for determining MI. Also, Bland‐Altman analysis is conducted between the two methods.

Results

Normal myocardium, infarcted myocardium, and blood are correctly identified using the proposed method. The clustered images correctly identified 90 ± 4% of the pixels defined as infarct in the DE images. In addition, 89 ± 5% of the pixels defined as infarct in the clustered images were also defined as infarct in DE images. The Bland‐Altman results show no bias between the two methods in identifying MI.

Conclusion

The proposed technique allows for objectively identifying divergent heart tissues, which would be potentially important for clinical decision‐making in patients with MI. J. Magn. Reson. Imaging 2008;28:519–526. © 2008 Wiley‐Liss, Inc.
Comparison of T1 and T2 metabolite relaxation times in glioma and normal brain at 3T
Authors: Li Yan , Srinivasan Radhika , Ratiney Helene , Lu Ying , Chang Susan M. , Nelson Sarah J.
Published: July 2008

Purpose

To measure T1 and T2 relaxation times of metabolites in glioma patients at 3T and to investigate how these values influence the observed metabolite levels.

Materials and Methods

A total of 23 patients with gliomas and 10 volunteers were studied with single‐voxel two‐dimensional (2D) J‐resolved point‐resolved spectral selection (PRESS) using a 3T MR scanner. Voxels were chosen in normal appearing white matter (WM) and in regions of tumor. The T1 and T2 of choline containing compounds (Cho), creatine (Cr), and N‐acetyl aspartate (NAA) were estimated.

Results

Metabolite T1 relaxation values in gliomas were not significantly different from values in normal WM. The T2 of Cho and Cr were statistically significantly longer for grade 4 gliomas than for normal WM but the T2 of NAA was similar. These differences were large enough to impact the corrections of metabolite levels for relaxation times with tumor grade in terms of metabolite ratios (P < 0.001).

Conclusion

The differential increase in T2 for Cho and Cr relative to NAA means that the ratios of Cho/NAA and Cr/NAA are higher in tumor at longer echo times (TEs) relative to values in normal appearing brain. Having this information may be useful in defining the acquisition parameters for optimizing contrast between tumor and normal tissue in MR spectroscopic imaging (MRSI) data, in which limited time is available and only one TE can be used. J. Magn. Reson. Imaging 2008;28:342–350. © 2008 Wiley‐Liss, Inc.
Monitoring of early response to neoadjuvant chemotherapy in breast cancer with 1H MR spectroscopy: Comparison to sequential 2‐[18F]‐fluorodeoxyglucose positron emission tomography
Authors: Tozaki Mitsuhiro , Sakamoto Masaaki , Oyama Yu , O'uchi Toshihiro , Kawano Naoko , Suzuki Takako , Yamashiro Norie , Ozaki Shinji , Sakamoto Naomi , Higa Kuniki , Abe Satoko , Ogawa Tomoko , Fukuma Eisuke
Published: July 2008

Purpose

To assess the efficacy of 1H MR spectroscopy (MRS) to evaluate early responses to neoadjuvant chemotherapy in breast cancer patients, as compared to that of the standardized uptake value (SUV) in 18F‐fluorodeoxyglucose (FDG) positron emission tomography (PET).

Materials and Methods

This retrospective study included seven patients with breast cancer who had both single‐voxel 1H MRS and PET/computed tomography (CT) acquired before, during, and after neoadjuvant chemotherapy.

Results

The averages of the Choline (Cho) integral value and peak SUV before chemotherapy were 2.5 (range, 1.2–5.3) and 7.5 (range, 1.9–19), respectively. Three cases became negative for both Cho and peak SUV after two cycles of chemotherapy, and one patient became negative before surgery. In the remaining three patients, the curves of both values paralleled the time course of chemotherapy treatment. The difference between Cho and peak SUV before, during, and after chemotherapy was r = 0.65 (P = 0.12), r = 0.80 (P = 0.03), and r = 0.99 (P < 0.001), respectively. The reduction rate (RR) of both values after chemotherapy was also correlated (r = 0.84, P = 0.02).

Conclusion

A change in the Cho integral value is well correlated with that of peak SUV in the time course of neoadjuvant chemotherapy; thus, breast 1H MRS is thought to be an alternative to sequential 18F‐FDG PET. J. Magn. Reson. Imaging 2008;28:420–427. © 2008 Wiley‐Liss, Inc.
MRI vs. ultrasound for suspected appendicitis during pregnancy
Authors: Israel Gary M. , Malguria Nagina , McCarthy Shirley , Copel Josh , Weinreb Jeffrey
Published: July 2008

Purpose

To compare the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ultrasound (US) and MRI in evaluation of pregnant patients with a clinical suspicion of appendicitis.

Materials and Methods

A total of 33 pregnant patients with suspected appendicitis underwent US and MRI. The original imaging reports generated at the time of presentation were used for data analysis. Pathology reports were used for disease confirmation in patients who underwent appendectomy. When surgery was not performed, a medical record review was performed. The sensitivity, specificity, PPV, and NPV were calculated for US and MRI in the diagnosis of appendicitis.

Results

Five of the 33 patients had pathologically‐proven appendicitis. Four of the five patients with appendicitis were correctly diagnosed at MRI while one was interpreted as indeterminate (appendix not seen). At US, one was correctly diagnosed, one was incorrectly diagnosed as normal, and three were interpreted as indeterminate (appendix not seen). In 13 patients, a normal appendix was diagnosed at MRI, none of whom had appendicitis. In three patients, a normal appendix was diagnosed at US, one of whom had appendicitis. When the appendix was visualized at MRI, the sensitivity, specificity, PPV, and NPV for the diagnosis of appendicitis was 100% for all parameters. When the appendix was visualized at US, the sensitivity, specificity, PPV, and NPV for the diagnosis of appendicitis was 50%, 100%, 100%, and 66%, respectively.

Conclusion

Based on a relatively small number of true‐positives, our data suggests that MRI is very useful for the diagnosis and exclusion of appendicitis in pregnant women. J. Magn. Reson. Imaging 2008;28:428–433. © 2008 Wiley‐Liss, Inc.
Diffusion MRI in ischemic epiphysis of the femoral head: An experimental study
Authors: Li Xiaoming , Qi Jianpin , Xia Liming , Li Honglian , Hu Junwu , Yu Cheng , Pen Wenjia , Guan Jian , Hu Daoyu
Published: July 2008

Purpose

To evaluate whether line‐scan diffusion‐weighted imaging (LSDWI) can provide temporal information of epiphyseal ischemia.

Materials and Methods

Ischemia was induced by ligation of arteries of the unilateral femoral head in piglets (N = 25). LSDWI was performed at several time points after ligation. A comparison of apparent diffusion coefficients (ADCs) was made between ischemic and control sides. The difference in percentage change of ADC in the ischemic hips between two neighboring time points was evaluated. A histological study was made after MR scanning.

Results

Three hours after ligation, ADCs were significantly lower in the ischemic hips than in the contralateral (control) hips. At 72 hours after surgery, ADCs in the ischemic hips were significantly higher than in the control hips and continued to rise up until the sixth week after operation. Histological study revealed necrosis of chondrocytes and osteocytes and abnormal thickening of the epiphyseal cartilage in the ischemic femoral head.

Conclusion

The ADCs may be used as a marker of ischemia and necrosis in the femoral head; changes in the ADCs after the acute ischemia may reflect the evolution of ischemia and subsequent necrosis. LSDWI can be used for the evaluation of the duration and extent of ischemic injury in the epiphysis. J. Magn. Reson. Imaging 2008;28:471–477. © 2008 Wiley‐Liss, Inc.
MR findings of meniscal extrusion correlated with arthroscopy
Authors: Magee Thomas
Published: July 2008

Purpose

To correlate MR exams showing meniscal extrusions >3 mm beyond the tibial margin with arthroscopic findings. Meniscal extrusion (>3 mm extension beyond the tibial margin) has been described on previous studies as having a high index of association with meniscal root tears. These previous studies were limited by a lack of exact arthroscopic correlation. We also assessed the prevalence of meniscal root tears on MR examinations without meniscal extrusions.

Materials and Methods

A retrospective review was performed of 300 consecutive knee MR exams of patients who went on to arthroscopy. All patients had a complete MR exam performed on a 3T GE MR scanner. MR exams were reviewed for medial meniscal extrusion >3 mm from the tibial margin. The exams with medial meniscal extrusion were reviewed for meniscal tears on MR exam. The exams without meniscal extrusion were reviewed for meniscal root tears. Results were subsequently correlated with arthroscopy.

Results

Of the 300 MR exams, 42 demonstrated medial meniscal extrusion >3 mm from the tibial margin. Of these 42 patients, 34 had meniscal degeneration, complex tear, or a large radial tear near to or involving the meniscal root on MR examination. A total of 33 of these tears described on MR exam were seen at arthroscopy. A total of 24 of these tears were root tears, seven were complex tears, and two had severe meniscal degeneration. There was one root tear described on MR exam that was not seen on arthroscopy. Eight of the 42 patients had no meniscal tear demonstrated on MR examination or arthroscopy. All eight of these patients were ≥50 years old. There were two meniscal root tears on both MR exam and at arthroscopy in the 258 patients without meniscal extrusion on MR exam.

Conclusion

There is a high prevalence of meniscal root tears in patients with meniscal extrusion on MR exam. Meniscal root tears are uncommon in patients without meniscal extrusion on MR exam. There may be a subset of patients in which the meniscal root is stretched rather than torn. Medial meniscal extrusion in patients >50 years old may be associated with a meniscal “stretch” injury due to degeneration of the meniscus without a meniscal tear detectable on arthroscopy. These menisci may have increased laxity due to compromised meniscal collagen fibers. This may predispose the patient to premature osteoarthritis. J. Magn. Reson. Imaging 2008;28:466–470. © 2008 Wiley‐Liss, Inc.
Relevance of b‐values in evaluating liver fibrosis: A study in healthy and cirrhotic subjects using two single‐shot spin‐echo echo‐planar diffusion‐weighted sequences
Authors: Girometti Rossano , Furlan Alessandro , Esposito Gennaro , Bazzocchi Massimo , Como Giuseppe , Soldano Franca , Isola Miriam , Toniutto Pierluigi , Zuiani Chiara
Published: July 2008

Purpose

To investigate the relevance of increasing b‐values in evaluating liver fibrosis through the agreement of two diffusion‐weighted (DW) sequences.

Materials and Methods

A total of 29 cirrhotic patients and 29 healthy volunteers were studied on a 1.5T system. Two single‐shot spin‐echo echo‐planar sequences were acquired using sets of increasing b‐values: 0, 150, 250, and 400 seconds/mm2 (first sequence: DW1a) and 0, 150, 250, 400, 600, and 800 seconds/mm2 (second sequence: DW2a). Apparent diffusion coefficients (ADCs) of the hepatic parenchyma were calculated on ADC maps. Noise‐scaled single‐point ADCs were calculated for each sequence from b = 400 seconds/mm2.

Results

ADCs resulted significantly lower in cirrhotic patients compared to controls using both DW1a (mean 1.14 ± 0.20 × 10−3mm2/second vs. 1.54 ± 0.12 × 10−3mm2/second; P < 0.0001) and DW2a (mean 0.91 ± 0.18 × 10−3mm2/second vs. 1.04 ± 0.18 × 10−3mm2/second; P = 0.0089). DW1 and DW2, respectively significantly differed in diagnostic performance at receiver operating characteristic (ROC) curve analysis (P = 0.003), showing AUCs of 0.93 (sensitivity 89.7%, specificity 100%) and 0.73 (sensitivity 62.1%, specificity 79.3%), respectively. Noise‐scaled single‐point ADCs showed a progressive convergence to similar values in cirrhotic and healthy livers at b = 800 seconds/mm2 (1.12 ± 0.27 × 10−3mm2/second vs. 1.13 ± 0.17 × 10−3mm2/second).

Conclusion

A DW sequence is accurate in assessing liver fibrosis using intermediate (400 seconds/mm2) rather than high (800 seconds/mm2) maximum b‐values, but after proper recalculation of ADCs the effects of perfusion rather than diffusion should be considered responsible for the higher accuracy at lower b‐values. J. Magn. Reson. Imaging 2008;28:411–419. © 2008 Wiley‐Liss, Inc.
Vitamin C estimation with standard 1H spectroscopy using a clinical 3T MR system: Detectability and reliability within the human brain
Authors: Shih Yi‐Yu , Büchert Martin , Chung Hsiao‐Wen , Hennig Jürgen , von Elverfeldt Dominik
Published: July 2008

Purpose

To evaluate whether vitamin C is detectable using clinical routine MRS combined with LCModel analysis and verify the reliability of its estimated concentration.

Materials and Methods

In order to determine the reliability of the estimated ascorbic acid (Asc) concentrations, we analyzed 76 in vivo single voxel spectra (SVS) acquired on a 3T scanner (point‐resolved spectroscopy with TE = 30 ms, TR = 3000 ms, voxel size = 8 mL, without spectral editing) from different regions within the brain using LCModel. In addition to this we simulated multiple concentration levels by adding adapted Asc spectra to the in vivo data.

Results

Asc was successfully detected in 71 of 76 in vivo spectra with a comparable concentration ratio to that of myo‐inositol. Furthermore, we observed good linearity between added Asc concentrations and the LCModel estimates within the simulations having correlation coefficients larger than 0.985 at three different linewidth cases.

Conclusion

This study demonstrates the ability to detect vitamin C in the human brain under common clinical magnetic resonance spectroscopy (MRS) standards in combination with LCModel. Furthermore, it supports the need to include Asc in the standard MRS analysis. J. Magn. Reson. Imaging 2008;28:351–358. © 2008 Wiley‐Liss, Inc.
Raman spectroscopy in art and archaeology
Authors: Baraldi Pietro , Tinti Anna
Published: July 2008

This paper introduces presentations given at the fourth International Conference on the Application of Raman Spectroscopy in Art and Archaeology, held in Modena, Italy, in the Ducal Palace, on 5–8 September 2007. The subjects of lectures and posters presented were concerned mainly with the new applications of Raman microscopy and other Raman techniques to more problematic samples, such as lakes, inks, and fluorescent dyes. Chronologically, the applications extended from the 10th century BC to the present day. The areas considered in the research were wide‐ranging in terms of subject‐matter and also geographically. New techniques have been developed for the study of binders in paintings and lakes, and with movable instrumentation on unmovable samples. Copyright © 2008 John Wiley & Sons, Ltd.
Isolated limb perfusion with tumor necrosis factor and melphalan for non‐resectable soft tissue sarcomas: Long‐term results on efficacy and limb salvage in a selected group of patients
Authors: Cherix Stéphane , Speiser Mélanie , Matter Maurice , Raffoul Wassim , Liénard Danièle , Theumann Nicolas , Mouhsine Elyazid , Mirimanoff René‐Olivier , Leyvraz Serge , Lejeune Ferdy J , Leyvraz Pierre‐François
Published: July 2008

Background and Objectives

Isolated limb perfusion with TNF‐alpha and melphalan (TM‐ILP) is a limb salvage therapy for non‐resectable soft tissue sarcomas (STS) of the extremities. It is indicated for patients for whom amputation or debilitating surgery is the only alternative. It can be used either as an exclusive therapy (in palliation) or as a neo‐adjuvant treatment, followed by marginal resection of tumor remnants with minimal functional impairment.

Methods

Between February 1992 and March 2006, 57 TM‐ILPs were performed on 51 patients with 88% high grade and 84% advanced stage tumors.

Results

Mean follow‐up is 38.9 months (4–159, median 22 months). Twenty‐one percent patients had significant early complications, with 3 major re‐operations, and 23% suffered long‐lasting complications. Complete response was observed in 25%, partial response in 42%, stable disease in 14% and progressive disease in 14%. Resection of the tumor remnants was possible in 65%. A complementary treatment was necessary in 31%, mostly radiation therapy. A local recurrence was observed in 35%, after a mean of 20.3 months (2–78), and distant relapse was seen in 45%, after a mean of 13.4 months (5–196). Mean Disease‐free survival was 14.9 months, and overall 5‐year‐survival 43.5%. Amputation rate at 5 years was 24%.

Conclusions

TM‐ILP is a conservative treatment with a high complications rate, but it can be successful even for the most severe STS of extremities. As a consequence the limb can be spared from amputation or debilitating surgery on the long term in about 75% of patients. J. Surg. Oncol. 2008;98:148–155. © 2008 Wiley‐Liss, Inc.
The most appropriate category of metastatic lymph nodes to evaluate overall survival of gastric cancer following curative resection
Authors: Deng Jing‐Yu , Liang Han , Sun Dan , Zhan Hong‐Jie , Wang Xiao‐Na
Published: July 2008

Aims

The purpose of this study was to provide a nodal grouping category based on metastatic lymph nodes to evaluate overall survival in gastric cancer patients following curative resection (R0).

Patients and Methods

We reviewed data of 308 gastric cancer patients following curative resection to evaluate significantly survival differences in different categories of the number of metastatic lymph nodes.

Results

In 308 evaluable patients, 5‐year survival rate (YSR) was 52.9% (median follow‐up, 84 months; range, 6–144 months). A total of 6309 lymph nodes were harvested and examined from all 308 patients, and the average number of lymph nodes harvested for per patient was 20.5 (range, 15–49). The average number of metastatic lymph nodes was 5.4 (range, 0–37) per patient. The initial metastatic node cutoffs were designed as 0, 1–4, 5–8, 9–11, 12–16, and ≥17. According to this new category of the number of metastatic lymph nodes, the 5‐YSR of various patient groups were 85.7%, 62.8%, 34.3%, 0%, 0%, and 3.4%, respectively. However, we found that there were not significant prognostic differences between patients with 9 metastatic lymph nodes and patients with more than 9 metastatic lymph nodes (P > 0.05). So we redesigned the later cutoffs of number of metastatic lymph nodes. They were as follows: 0, 1–4, 5–8, and ≥9 of metastatic lymph nodes. We demonstrated this new category of the number of metastatic lymph nodes was more appropriate to evaluate overall survival of gastric cancer patients following curative resection than anyone of the current metastatic lymph nodal stagings (such as N stag in UICC, location of metastatic lymph nodes in JCGC, or ratio of metastatic lymph nodes) by using the case‐control matched fashion.

Conclusions

Our new category of the number of metastatic lymph nodes was an important prognostic factor of gastric cancer patients following curative resection. There were significant overall survival differences in gastric cancer patient groups with various numbers of metastatic lymph nodes following curative resection. J. Surg. Oncol. 2008;98:343–348. © 2008 Wiley‐Liss, Inc.
A systematic review on the clinical diagnosis of gastrointestinal stromal tumors
Authors: Scarpa Marco , Bertin Matteo , Ruffolo Cesare , Polese Lino , D'Amico Davide F. , Angriman Imerio
Published: July 2008

Background

The aim of this work was to assess the prevalence of symptoms of gastrointestinal stromal tumors (GISTs) and the diagnostic yield of clinical procedures for its diagnosis.

Methods

Medical databases were consulted between 1998 and 2006 for potentially relevant publications. All studies dealing with the clinical presentation of GIST and related diagnostic procedures were included. Two researchers worked independently on the study selection, quality assessment, data extraction, and analysis phases of the study.

Results

Forty‐six observational studies were included with a total of 4,534 patients. Gastrointestinal bleeding was the most common clinical presentation. Twenty studies provided adequate information on the diagnostic yield of various procedures. The pooled diagnostic yield of endoscopy + mucosal biopsy and of intestinal contrast radiography was 33.8% (0–100%) and 35.1% (11–100%), respectively, while that of EUS and that of EUS‐FNA was 68.7% (40–100%) and 84.0% (73.8–100%), respectively. Abdominal CT scan and MRI had similar pooled diagnostic yields: 73.6% (34.8–100%), and 91.7% (75–100%), respectively.

Conclusion

Endoscopy + mucosal biopsy should be reserved to patients with gastrointestinal bleeding. EUS‐FNA provides direct visualization of the neoplasm and adequate samples for molecular diagnosis. EUS, abdominal CT and MRI may be considered valid alternatives whenever EUS‐FNA is unavailable or a cytological diagnosis is unnecessary. J. Surg. Oncol. 2008;98:384–392. © 2008 Wiley‐Liss, Inc.
Is pleomorphic lobular carcinoma really a distinct clinical entity?
Authors: Buchanan Claire L. , Flynn Laurie W. , Murray Melissa P. , Darvishian Farbod , Cranor Milicent L. , Fey Jane V. , King Tari A. , Tan Lee K. , Sclafani Lisa M.
Published: July 2008

Background

Attempts to define the clinical behavior of pleomorphic lobular carcinoma (PLC) have been limited to small series, and clinical management strategies have yet to be established. We describe our experience with PLC as compared to classic ILC and invasive ductal carcinoma (IDC).

Methods

From 9/1996 to 5/2003, clinical and histopathologic data for 5,635 patients undergoing primary surgical treatment and sentinel lymph node biopsy for breast cancer were collected. Four hundred eighty one (8.5%) patients were diagnosed with ILC; 3,978 (70.6%) with IDC. Of those with ILC, 356 (74%) patients had material available for pathologic re‐review and comprise our study population: 52 were classified as PLC; 298 were classified as classic ILC; and 6 cases were reclassified as IDC. We compared clinical, pathologic, and treatment factors for patients with PLC, ILC, and IDC using the Wilcoxon rank sum and Fisher's exact tests.

Results

PLC were larger than ILC and IDC (20 vs. 15 vs. 13, P < 0.001), had more positive nodes (median 1 vs. 0 vs. 0, P < 0.05) and more frequently required mastectomy (63.5% vs. 38.7% vs. 28.8%, P < 0.001). In addition, more patients with PLC had developed metastatic disease compared to patients with ILC (11.5% vs. 3.7%, P < 0.05).

Conclusions

These findings suggest that PLC is a distinct clinical entity that presents at a more advanced stage and may require more aggressive surgical and adjuvant treatment. J. Surg. Oncol. 2008;98:314–317. © 2008 Wiley‐Liss, Inc.
Oncological and functional results of cryosurgical therapy of enchondromas and chondrosarcomas grade 1
Authors: van der Geest I.C.M. , de Valk M.H. , de Rooy J.W.J. , Pruszczynski M. , Veth R.P.H. , Schreuder H.W.B.
Published: July 2008

Background and Objectives

Cryosurgery using liquid nitrogen is used as adjuvant treatment after intralesional resection of bone tumours to induce cell death. It is applied to enlarge the oncological margins of resection and to reduce the local recurrence rate. The objective of this study is to analyze the oncological and functional results.

Methods

We studied the oncological and functional results of curettage and cryosurgery in 123 patients with 130 tumors. There were 75 enchondromas and 55 chondrosarcomas grade 1. The minimal follow‐up period for all patients was 2 years (range 24–119 months).

Results

During follow‐up one local recurrence of an active enchondroma and one local recurrence of an aggressive enchondroma occurred. They were treated with curettage and cryosurgery again. Both patients were disease‐free at minimum of 3 years follow‐up. No local recurrences after treatment of chondrosarcoma grade 1 were seen. Functional scores, according to the MSTS scoring system, showed an average score of 28 points (94%) at 2 years follow‐up. Post‐operative fractures were seen in 18 patients (14%).

Conclusions

Curettage and cryosurgery for enchondroma and chondrosarcoma grade 1 has excellent oncological and functional results. The post‐operative management has been adjusted to reduce the number of fractures. J. Surg. Oncol. © 2008 Wiley‐Liss, Inc.
High expression of human nonmetastatic clone 23 type 1 in cancer of uterine cervix and its association with poor cell differentiation and worse overall survival
Authors: Hsu Chien‐Gang , Lin Long‐Yau , Ko Jiunn‐Liang , Yang Shun‐Fa , Chang Han , Lin Ching‐Yi , Tsai Hsiu‐Ting , Chen Shiuan‐Chih , Chen Shu‐Chen , Wang Po‐Hui
Published: July 2008

Background and Objectives

The role of human nonmetastatic clone 23 type 1 (nm23‐H1), a metastasis‐associated gene, is less clear‐cut in cancer of uterine cervix; therefore, we investigate its expression in cancer tissues and its correlation with clinicopathologic variables and survival of patients.

Methods

Thirty cervical cancer tissues and their normal counterparts were collected to evaluate quantitative nm23‐H1 mRNA expression. From them, 16 cancer and 16 normal tissues were collected and added with another 64 cancer tissues to construct a 96‐tissue core microarray for immunohistochemical study. We evaluated the relationships among nm23‐H1 immunostaining using semi‐quantitative H scores, clinicopathologic parameters, recurrence and survival in cervical cancer patients.

Results

Nm23‐H1 mRNA expression and H score (median H scores: 2.0 vs. 0.3, P = 0.001) were higher in cervical cancer tissues than normal counterparts, respectively. Nm23‐H1 expression was significantly associated with depth of stromal invasion (P = 0.003), tumor diameter (P = 0.044) and cell differentiation (P = 0.025). Other than stage II, poor cell differentiation as well as positive parametrium invasion and lymph node metastasis, positive nm23‐H1 expression was significantly correlated with poor overall survival.

Conclusion

High nm23‐H1 expression is predictive of worse overall survival for cervical cancer patients. J. Surg. Oncol. © 2008 Wiley‐Liss, Inc.
Multiparametric analysis of amino acids and organic acids in rat brain tissues using GC/MS
Authors: Lin Jingchao , Su Mingming , Wang Xiaoyan , Qiu Yunping , Li Houkai , Hao Jin , Yang Hongzhou , Zhou Mingmei , Yan Chao , Jia Wei
Published: July 2008

Using design of experiment (DOE) theory coupled with multivariate statistical analysis, we have developed a simple and reliable GC/MS‐based analytical assay for simultaneous analysis of amino acids and organic acids in rat brain tissue samples. The process of water extraction (pH 10.0) was extensively evaluated using brain tissue samples and a set of 21 reference standards. Acceptable calibration curves were obtained over a wide concentration range, 0.2–35.0 μg/mL for standards and 15.0–2.4 mL/g (tissue) for brain tissue samples. The precision was mostly better than 10% for both the mixed standards and the brain tissue samples. The brain tissue samples exhibited good stability within 48 h with RSD generally less than 15%. Furthermore, the developed analytical method was successfully applied in distinguishing the subtle variation among different parts of the brain tissues, such as cerebral cortex, hippocampus, and thalamus.
Determination of primary biogenic amines in various food products using isocratic HPLC with 3‐(4‐chlorobenzoyl)‐quinoline‐2‐carboxaldehyde as a new precolumn fluorogenic reagent
Authors: Zhang Niu , Wang Hong , Guo Xiao‐Feng , Zhang Hua‐Shan
Published: July 2008

A simple HPLC approach has been successfully established for the sensitive determination of six biogenic amines (BAs) in food samples. The method involves derivatization with 3‐(4‐chlorobenzoyl)‐quinoline‐2‐carboxaldehyde newly synthesized as a new fluorogenic reagent followed by LC isocratic elution mode. The optimization of both derivatization and separation conditions is carefully studied. Related analyses of the eluted compounds, in the presence of MeOH/THF/H2O (78:2.5:19.5 v/v/v) as a mobile phase containing 8 mM, pH 6.0 phosphate buffer solution, have been carried out on a C18 column. The LOD (S/N = 3) of 2.5 nM, RSD value from 1.0 to 5.1% in peak areas, and good response linearity (R2 >0.9936) are provided with fluorescence detection at λex/λem = 480/545 nm. Obviously, recovery ranging from 95 to 107% in this method demonstrates its accuracy for determination of histamine, tyramine, 2‐phenylethylamine, putrescine, cadaverine, and spermidine in the storage fish sample. Thus, the present method could be developed to monitor BAs in fish, cucumber, and spinach samples.
Spatial distribution of RF‐induced E‐fields and implant heating in MRI
Authors: Nordbeck Peter , Fidler Florian , Weiss Ingo , Warmuth Marcus , Friedrich Michael T. , Ehses Philipp , Geistert Wolfgang , Ritter Oliver , Jakob Peter M. , Ladd Mark E. , Quick Harald H. , Bauer Wolfgang R.
Published: July 2008

The purpose of this study was to assess the distribution of RF‐induced E‐fields inside a gel‐filled phantom of the human head and torso and compare the results with the RF‐induced temperature rise at the tip of a straight conductive implant, specifically examining the dependence of the temperature rise on the position of the implant inside the gel. MRI experiments were performed in two different 1.5T MR systems of the same manufacturer. E‐field distribution inside the liquid was assessed using a custom measurement system. The temperature rise at the implant tip was measured in various implant positions and orientations using fluoroptic thermometry. The results show that local E‐field strength in the direction of the implant is a critical factor in RF‐related tissue heating. The actual E‐field distribution, which is dependent on phantom/body properties and the MR‐system employed, must be considered when assessing the effects of RF power deposition in implant safety investigations. Magn Reson Med 60:312–319, 2008. © 2008 Wiley‐Liss, Inc.
Fast, exact k‐space sample density compensation for trajectories composed of rotationally symmetric segments, and the SNR‐optimized image reconstruction from non‐Cartesian samples
Authors: Mitsouras Dimitris , Mulkern Robert V. , Rybicki Frank J.
Published: July 2008

A recently developed method for exact density compensation of non uniformly arranged samples relies on the analytically known cross‐correlations of Fourier basis functions corresponding to the traced k‐space trajectory. This method produces a linear system whose solution represents compensated samples that normalize the contribution of each independent element of information that can be expressed by the underlying trajectory. Unfortunately, linear system‐based density compensation approaches quickly become computationally demanding with increasing number of samples (i.e., image resolution). Here, it is shown that when a trajectory is composed of rotationally symmetric interleaves, such as spiral and PROPELLER trajectories, this cross‐correlations method leads to a highly simplified system of equations. Specifically, it is shown that the system matrix is circulant block‐Toeplitz so that the linear system is easily block‐diagonalized. The method is described and demonstrated for 32‐way interleaved spiral trajectories designed for 256 image matrices; samples are compensated non iteratively in a few seconds by solving the small independent block‐diagonalized linear systems in parallel. Because the method is exact and considers all the interactions between all acquired samples, up to a 10% reduction in reconstruction error concurrently with an up to 30% increase in signal to noise ratio are achieved compared to standard density compensation methods. Magn Reson Med 60:339–349, 2008. © 2008 Wiley‐Liss, Inc.
Ischemia‐induced changes of intracellular water diffusion in rat glioma cell cultures
Authors: Trouard Theodore P. , Harkins Kevin D. , Divijak Joseph L. , Gillies Robert J. , Galons Jean‐Philippe
Published: July 2008

Diffusion‐weighted MRI is commonly used in the diagnosis and evaluation of ischemic stroke because of the rapid decrease observed in the apparent diffusion coefficient (ADC) of tissue water following ischemia. Although this observation has been clinically useful for many years, the biophysical mechanisms underlying the reduction of tissue ADC are still unknown. To help elucidate these mechanisms, we have employed a novel three‐dimensional (3D) hollow‐fiber bioreactor (HFBR) perfused cell culture system that enables cells to be grown to high density and studied via MRI and MRS. By infusing contrast media into the HFBR, signals from intracellular water and extracellular water are spectroscopically resolved and can be investigated individually. Diffusion measurements carried out on C6 glioma HFBR cell cultures indicate that ischemia‐induced cellular swelling results in an increase in the ADC of intracellular water from 0.35 μm2/ms to approximately 0.5 μm2/ms (diffusion time = 25 ms). Magn Reson Med 60:258–264, 2008. © 2008 Wiley‐Liss, Inc.
Quantitative evaluation of oxygenation in venous vessels using T2‐Relaxation‐Under‐Spin‐Tagging MRI
Authors: Lu Hanzhang , Ge Yulin
Published: July 2008

Noninvasive measurement of cerebral venous oxygenation can serve as a tool for better understanding fMRI signals and for clinical evaluation of brain oxygen homeostasis. In this study a novel technique, T2‐Relaxation‐Under‐Spin‐Tagging (TRUST) MRI, is developed to estimate oxygenation in venous vessels. This method uses the spin labeling principle to automatically isolate pure blood signals from which T2 relaxation times are determined using flow‐insensitive T2‐preparation pulses. The blood T2 is then converted to blood oxygenation using a calibration plot. In vivo experiments gave a baseline venous oxygenation of 64.8 ± 6.3% in sagittal sinus in healthy volunteers (n = 24). Reproducibility studies demonstrated that the standard deviation across trials was 2.0 ± 1.1%. The effects of repetition time and inversion time selections were investigated. The TRUST technique was further tested using various physiologic challenges. Hypercapnia induced an increase in venous oxygenation by 13.8 ± 1.1%. On the other hand, caffeine ingestion resulted in a decrease in oxygenation by 7.0 ± 1.8%. Contrast agent infusion (Gd‐DTPA, 0.1 mmol/kg) reduced venous blood T2 by 11.2 ms. The results of this study show that TRUST MRI is a useful technique for quantitative assessment of blood oxygenation in the brain. Magn Reson Med 60:357–363, 2008. © 2008 Wiley‐Liss, Inc.
Convertible manganese contrast for molecular and cellular MRI
Authors: Shapiro Erik M. , Koretsky Alan P.
Published: July 2008

We describe here the use of inorganic manganese based particles as convertible MRI agents. As has been demonstrated with iron oxide particles, manganese oxide and manganese carbonate particles can be internalized within phagocytotic cells, being subsequently shuttled to endosomes and/or lysosomes. As intact particles, only susceptibility‐induced MRI contrast is exhibited, most often seen as dark contrast in susceptibility‐weighted images. Modulation of MRI contrast is accomplished by the selective degradation of these particles within the endosomal and lysosomal compartments of cells. Upon particle deconstruction in the endosomes and lysosomes, the dissolved Mn2+ acts as a T1 agent, eliciting bright contrast in T1‐weighted images. This modulation of MRI contrast is demonstrated both in vitro in cells in culture, and also in vivo, in rat brain. These particles are the potential building blocks for an entire class of new environmentally responsive MRI contrast agents. Magn Reson Med 60:265–269, 2008. © 2008 Wiley‐Liss, Inc.
Using GRAPPA to improve autocalibrated coil sensitivity estimation for the SENSE family of parallel imaging reconstruction algorithms
Authors: Hoge W. Scott , Brooks Dana H.
Published: July 2008

Two strategies are widely used in parallel MRI to reconstruct subsampled multicoil image data. SENSE and related methods employ explicit receiver coil spatial response estimates to reconstruct an image. In contrast, coil‐by‐coil methods such as GRAPPA leverage correlations among the acquired multicoil data to reconstruct missing k‐space lines. In self‐referenced scenarios, both methods employ Nyquist‐rate low‐frequency k‐space data to identify the reconstruction parameters. Because GRAPPA does not require explicit coil sensitivities estimates, it needs considerably fewer autocalibration signals than SENSE. However, SENSE methods allow greater opportunity to control reconstruction quality though regularization and thus may outperform GRAPPA in some imaging scenarios. Here, we employ GRAPPA to improve self‐referenced coil sensitivity estimation in SENSE and related methods using very few auto‐calibration signals. This enables one to leverage each methods' inherent strength and produce high quality self‐referenced SENSE reconstructions. Magn Reson Med 60:462–467, 2008. © 2008 Wiley‐Liss, Inc.
Rapid magnetic resonance quantification on the brain: Optimization for clinical usage
Authors: Warntjes J.B.M. , Leinhard O. Dahlqvist , West J. , Lundberg P.
Published: July 2008

A method is presented for rapid simultaneous quantification of the longitudinal T1 relaxation, the transverse T2 relaxation, the proton density (PD), and the amplitude of the local radio frequency B1 field. All four parameters are measured in one single scan by means of a multislice, multiecho, and multidelay acquisition. It is based on a previously reported method, which was substantially improved for routine clinical usage. The improvements comprise of the use of a multislice spin‐echo technique, a background phase correction, and a spin system simulation to compensate for the slice‐selective RF pulse profile effects. The aim of the optimization was to achieve the optimal result for the quantification of magnetic resonance parameters within a clinically acceptable time. One benchmark was high‐resolution coverage of the brain within 5 min. In this scan time the measured intersubject standard deviation (SD) in a group of volunteers was 2% to 8%, depending on the tissue (voxel size = 0.8 × 0.8 × 5 mm). As an example, the method was applied to a patient with multiple sclerosis in whom the diseased tissue could clearly be distinguished from healthy reference values. Additionally it was shown that, using the approach of synthetic MRI, both accurate conventional contrast images as well as quantification maps can be generated based on the same scan. Magn Reson Med 60:320–329, 2008. © 2008 Wiley‐Liss, Inc.
Assessment of liver viscoelasticity using multifrequency MR elastography
Authors: Asbach Patrick , Klatt Dieter , Hamhaber Uwe , Braun Jürgen , Somasundaram Rajan , Hamm Bernd , Sack Ingolf
Published: July 2008

MR elastography (MRE) allows the noninvasive assessment of the viscoelastic properties of human organs based on the organ response to oscillatory shear stress. Shear waves of a given frequency are mechanically introduced and the propagation is imaged by applying motion‐sensitive gradients. An experiment was set up that introduces multifrequency shear waves combined with broadband motion sensitization to extend the dynamic range of MRE from one given frequency to, in this study, four different frequencies. With this approach, multiple wave images corresponding to the four driving frequencies are simultaneously acquired and can be evaluated with regard to the dispersion of the complex modulus over the respective frequency. A viscoelastic model based on two shear moduli and one viscosity parameter was used to reproduce the experimental wave speed and wave damping dispersion. The technique was applied in eight healthy volunteers and eight patients with biopsy‐proven high‐grade liver fibrosis (grade 3–4). Fibrotic liver had a significantly higher (P < 0.01) viscosity (14.4 ± 6.6 Pa · s) and elastic moduli (2.91 ± 0.84 kPa; 4.83 ± 1.77 kPa) than the viscosity (7.3 ± 2.3 Pa · s) and elastic moduli (1.16 ± 0.28 kPa; 1.97 ± 0.30 kPa) of normal volunteers. Multifrequency MRE is well suited for the noninvasive differentiation of normal and fibrotic liver as it allows the measurement of rheologic material properties. Magn Reson Med 60:373–379, 2008. © 2008 Wiley‐Liss, Inc.
The application of 23Na double‐quantum‐filter (DQF) NMR spectroscopy for the study of spinal disc degeneration
Authors: Ooms Kristopher J. , Cannella Marco , Vega Alexander J. , Marcolongo Michele , Polenova Tatyana
Published: July 2008

Degenerative disc disease is an irreversible process that leads to a loss of mechanical integrity and back pain in millions of people. In this report, 23Na double‐quantum‐filtered (DQF) NMR spectroscopy is used to study disc tissues in two stages of degeneration. Initial results indicate that the 23Na DQF signal may be useful for determining the degree of degeneration. The spectral analysis reveals the presence of sodium environments with different residual quadrupolar couplings and T2 relaxation times that we attribute to different regions, or compartments, corresponding to different biochemical regions in the tissue. In general it is found that there are compartments with no residual quadrupolar couplings, compartments with moderate couplings (200 to 1000 Hz), and compartments with couplings ranging from 1500 to 3000 Hz. The results indicate that 23Na DQF NMR spectroscopy provides a probe of the degenerative state of the intervertebral disc tissues, and might hold potential as a novel diagnostic method for detection of disc degeneration. Magn Reson Med 60:246–252, 2008. © 2008 Wiley‐Liss, Inc.