In 1988, the first contrast agent specifically designed for magnetic resonance imaging (MRI), gadopentetate dimeglumine (Magnevist®), became available for clinical use. Since then, a plethora of studies have investigated the potential of MRI contrast agents for diagnostic imaging across the body, including the central nervous system, heart and circulation, breast, lungs, the gastrointestinal, genitourinary, musculoskeletal and lymphatic systems, and even the skin. Today, after 25 years of contrast-enhanced (CE-) MRI in clinical practice, the utility of this diagnostic imaging modality has expanded beyond initial expectations to become an essential tool for disease diagnosis and management worldwide. CE-MRI continues to evolve, with new techniques, advanced technologies, and novel contrast agents bringing exciting opportunities for more sensitive, targeted imaging and improved patient management, along with associated clinical challenges. This review aims to provide an overview on the history of MRI and contrast media development, to highlight certain key advances in the clinical development of CE-MRI, to outline current technical trends and clinical challenges, and to suggest some important future perspectives.FundingBayer HealthCare.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-015-0275-4) contains supplementary material, which is available to authorized users.
Post-CRT DW MR volumetry provided high diagnostic performance in assessing CR and was significantly more accurate than T2-weighted MR volumetry. Post-CRT DW MR was equally as accurate as volume measurements of both T2-weighted and DW MR. Pre-CRT volumetry and ADC were not reliable.
• These guidelines recommend standardised imaging for staging and restaging of rectal cancer. • The guidelines were constructed through consensus amongst 14 abdominal imaging experts. • Consensus was reached by in 88 % of 236 items discussed.
Purpose: To assess the value of diffusion-weighted MR imaging (DWI) as a potential noninvasive marker of tumor aggressiveness in rectal cancer, by analyzing the relationship between tumoral apparent diffusion coefficient (ADC) values and MRI and histological prognostic parameters.Materials and Methods: Fifty rectal cancer patients underwent primary staging MRI including DWI before surgery and neo-adjuvant therapy. In 47, surgery was preceded by short-course radiation therapy (n ¼ 28) or long-course chemoradiation therapy (n ¼ 19). Mean tumor ADC was measured and compared between subgroups based on pretreatment CEA levels, MRI parameters (mesorectal fascia -MRF -status; T-stage; N-stage) and histological parameters (differentiation grade: poorly differentiated, poorly moderately differentiated, moderately differentiated, moderately well differentiated, welldifferentiated; lymphangiovascular invasion).Results: Mean tumor ADCs differ between MRF-free versus MRF-invaded tumors (P ¼ 0.013), the groups of cN0 versus cNþ cancers (P ¼ 0.011), and between the several groups of histological differentiation grades (P ¼ 0.025). There was no significant difference in mean ADCs between the various groups of CEA levels, the T stage, and the presence of lymphangiovascular invasion.
Conclusion:Lower ADC values were associated with a more aggressive tumor profile. Significant correlations were found between mean ADC values and radiological MRF status, N stage and differentiation grade. ADC has the potential to become an imaging biomarker of tumor aggressiveness profile.
ObjectivesTo develop a consensus and provide updated recommendations on liver MR imaging and the clinical use of liver-specific contrast agents.MethodsThe European Society of Gastrointestinal and Abdominal Radiology (ESGAR) formed a multinational European panel of experts, selected on the basis of a literature review and their leadership in the field of liver MR imaging. A modified Delphi process was adopted to draft a list of statements. Descriptive and Cronbach’s statistics were used to rate levels of agreement and internal reliability of the consensus.ResultsThree Delphi rounds were conducted and 76 statements composed on MR technique (n = 17), clinical application of liver-specific contrast agents in benign, focal liver lesions (n = 7), malignant liver lesions in non-cirrhotic (n = 9) and in cirrhotic patients (n = 18), diffuse and vascular liver diseases (n = 12), and bile ducts (n = 13). The overall mean score of agreement was 4.84 (SD ±0.17). Full consensus was reached in 22 % of all statements in all working groups, with no full consensus reached on diffuse and vascular diseases.ConclusionsThe consensus provided updated recommendations on the methodology, and clinical indications, of MRI with liver specific contrast agents in the study of liver diseases.Key points• Liver-specific contrast agents are recommended in MRI of the liver.• The hepatobiliary phase improves the detection and characterization of hepatocellular lesions.• Liver-specific contrast agents can improve the detection of HCC.
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