Evaluation of a free-breathing respiratory-triggered (Navigator) 3-D T1-weighted (T1W) gradient recalled echo sequence (LAVA) for detection of enhancement in cystic and solid renal masses

Tu, Wendy; Alzahrani, Abdulrahman; Currin, Stephen; Walsh, Cindy; Narayanasamy, Sabarish; McInnes, Matthew D. F.; Schieda, Nicola

doi:10.1007/s00330-018-5839-7

Cited by 8 publications

(6 citation statements)

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“…Artifacts evaluated on iodine overlay data set included misregistered iodine content signals seen on iodine maps, residual beam hardening on virtual monochromatic data sets, and image quality degradation occurring on dual-energy data sets in patient with elevated body mass index. 28 For MRI examinations, radiologists also evaluated: mass size (maximal dimension in millimeters), mass homogeneity (5-point Likert scale: completely heterogeneous, mostly heterogeneous, mixed areas of homogeneous and heterogeneous, mostly homogeneous, completely homogeneous), 8 subjective enhancement using CM phase and NG phase subtraction images, which were derived automatically by subtracting the precontrast fat-suppressed T1W data set from the postcontrast fat-suppressed T1W data set with the difference in the 2 data sets representing the subtraction image (5-point scale: definitely enhancing, likely enhancing, indeterminate, likely not-enhancing, definitely not enhancing), image quality of subtraction images (5-point scale: nondiagnostic, poor, average, above average, excellent), 12 and image artifact (motion, blur) of subtraction (5-point scale: severe, moderate, mild, minimal, none). 12…”

Section: Subjective Image Interpretationmentioning

confidence: 99%

“…This is particularly important in masses, which show intrinsically increased SI on precontrast T1W images, a common finding in papillary RCC, where adequately registered subtraction images (contrast-enhanced T1W – precontrast T1W) are critical to detect enhancement 2,9 . Investigators have explored using prospective and retrospective free-breathing techniques to improve image subtraction in renal MRI; however, results remain preliminary and lack validation 12,13 …”

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confidence: 99%

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Direct Comparison of Diagnostic Accuracy of Fast Kilovoltage Switching Dual-Energy Computed Tomography and Magnetic Resonance Imaging for Detection of Enhancement in Renal Masses

McGrath¹,

Ahmad²,

Sathiadoss³

et al. 2022

J Comput Assist Tomogr

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PurposeThe aim of the study was to compare diagnostic accuracy of dual-energy computed tomography (DECT) and magnetic resonance imaging (MRI) to detect enhancement in renal masses.MethodsAdults renal masses of 10 mm or greater with both fast kilovoltage potential switching DECT and contrast-enhanced MRI performed within 12 months were retrospectively included. Two blinded radiologists independently evaluated for enhancement subjectively (5-point Likert scales) and quantitatively (signal intensity ratio ≥15% for MRI, iodine concentration ≥1.2 or ≥2.0 mg/mL for DECT). Per-lesion diagnostic accuracy, with histologic reference standard for solid masses, was expressed as the area under the receiver operator curve (AUC) for each index test. Differences were evaluated for statistical significance using the DeLong test.ResultsWe included 24 patients with 41 masses: 17 solid renal masses and 24 Bosniak 1 or 2 cysts. There was no significant difference in diagnostic accuracy comparing subjective enhancement by MRI and using iodine overlay DECT for reader 1 (AUC 0.99 vs 0.99, P = 0.38) or reader 2 (AUC 1.00 vs 0.94, P = 0.12) Interobserver agreement was κ = 0.61 for DECT and κ = 0.71 for MRI. There was no significant difference either in accuracy between quantitative assessment using signal intensity ratio or iodine concentration for reader 1 (AUC 0.94 vs 0.94, P = 0.88) or reader 2 (AUC 0.97 vs 0.92, P = 0.16). False-negative results in both subjective and quantitative assessment were nearly exclusively seen in papillary renal cell carcinoma, occurring with both DECT and MRI.ConclusionsWe detected no significant differences in accuracy for detecting enhancement in renal masses comparing MRI and DECT. Our results require further investigation in larger sample sizes, but suggest that DECT may be comparable to MRI for detection of enhancement in renal masses.

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Section: Subjective Image Interpretationmentioning

confidence: 99%

mentioning

confidence: 99%

Direct Comparison of Diagnostic Accuracy of Fast Kilovoltage Switching Dual-Energy Computed Tomography and Magnetic Resonance Imaging for Detection of Enhancement in Renal Masses

McGrath¹,

Ahmad²,

Sathiadoss³

et al. 2022

J Comput Assist Tomogr

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“…28 It has been shown that use of free-breathing navigator-triggered 3D T 1 W GRE enables quality subtraction images that can be analyzed when breathhold subtraction is degraded by motion. 29 If free-breathing motion-compensated techniques are combined with advanced parallel imaging and compressed sensing, completely freebreathing studies including dynamic contrast enhanced (DCE)-MRI is possible. 27,28 Machine-learning techniques are expected to reduce exam times and artifacts even further.…”

Section: Mri Techniquementioning

confidence: 99%

“…14). 56 Lower Spatial Resolution MRI has a lower spatial resolution than CT. This is a limitation because lower spatial resolution can limit assessment of small structures.…”

Section: More Motion Artifactsmentioning

confidence: 99%

Update on MRI of Cystic Renal Masses Including Bosniak Version 2019

Krishna

Schieda

Pedrosa

et al. 2020

Magnetic Resonance Imaging

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Incidental cystic renal masses are common, usually benign, and almost always indolent. Since 1986, the Bosniak classification has been used to express the risk of malignancy in a cystic renal mass detected at imaging. Historically, magnetic resonance imaging (MRI) was not included in that classification. The proposed Bosniak v.2019 update has formally incorporated MRI, included definitions of imaging terms designed to improve interobserver agreement and specificity for malignancy, and incorporated a variety of masses that were incompletely defined or not included in the original classification. For example, at unenhanced MRI, homogeneous masses markedly hyperintense at T2‐weighted imaging (similar to cerebrospinal fluid) and homogeneous masses markedly hyperintense at fat suppressed T1‐weighted imaging (approximately ≥2.5 times more intense than adjacent renal parenchyma) are classified as Bosniak II and may be safely ignored, even when they have not been imaged with a complete renal mass MRI protocol. MRI has specific advantages and is recommended to evaluate masses that at computed tomography (CT) 1) have abundant thick or nodular calcifications; 2) are homogeneous, hyperattenuating, ≥3 cm, and nonenhancing; or 3) are heterogeneous and nonenhancing. Although MRI is generally excellent for characterizing cystic renal masses, there are unique weaknesses of MRI that bear consideration. These details and others related to MRI of cystic renal masses are described in this review, with an emphasis on Bosniak v.2019. A website (https://bosniak-calculator.herokuapp.com/) and mobile phone apps named “Bosniak Calculator” have been developed for ease of assignment of Bosniak classes.Level of Evidence5Technical Efficacy Stage3

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“…Regions of interest (ROI) corresponding to biopsy zones were extracted from axial slices as regions with consistent area of 1400 square pixels. Percentage signal intensity change ( % SIΔ) was extracted from the ROIs as previously described 66 . Additional quantitative imaging features (T2 Mean, T2 Entropy, T2 Skewness, and LAVA-Pre Kurtosis) were extracted and compared to published values on retrospective human clinical subjects with benign plexiform neurofibromas 40 .…”

Section: Skeletal Measurementsmentioning

confidence: 99%

Longitudinal phenotype development in a minipig model of neurofibromatosis type 1

Uthoff

Larson

Sato

et al. 2020

Sci Rep

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Neurofibromatosis type 1 (NF1) is a rare, autosomal dominant disease with variable clinical presentations. Large animal models are useful to help dissect molecular mechanisms, determine relevant biomarkers, and develop effective therapeutics. Here, we studied a NF1 minipig model (NF1 +/ex42del ) for the first 12 months of life to evaluate phenotype development, track disease progression, and provide a comparison to human subjects. Through systematic evaluation, we have shown that compared to littermate controls, the NF1 model develops phenotypic characteristics of human NF1: [1] café-au-lait macules, [2] axillary/inguinal freckling, [3] shortened stature, [4] tibial bone curvature, and [5] neurofibroma. At 4 months, full body computed tomography imaging detected significantly smaller long bones in NF1 +/ex42del minipigs compared to controls, indicative of shorter stature. We found quantitative evidence of tibial bowing in a subpopulation of NF1 minipigs. By 8 months, an NF1 +/ex42del boar developed a large diffuse shoulder neurofibroma, visualized on magnetic resonance imaging, which subsequently grew in size and depth as the animal aged up to 20 months. the NF1 +/ex42del minipig model progressively demonstrates signature attributes that parallel clinical manifestations seen in humans and provides a viable tool for future translational NF1 research.Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder with nearly 100% penetrance and an incidence of approximately 1 in every 3,000 births worldwide 1 . The clinical manifestations of the disorder are highly variable, even among individuals with the same mutation in NF1 1,2 . The most common phenotypic presentations of NF1 include café-au-lait macules (CALMs), axillary and inguinal freckling, optic pathway gliomas, pilocytic astrocytoma, and the presence of neurofibromas and plexiform neurofibromas (PNs) that have the potential to develop into malignant peripheral nerve sheath tumors (MPNSTs) 1-3 . Some individuals with NF1 may exhibit learning disabilities, increased pain, short stature, or macrocephaly at birth 3,4 . Although uncommon, they may also be born with or develop tibial bowing and sphenoid wing dysplasia 4 . Those affected by NF1 are also at increased risk of developing a number of different cancers including glioblastoma, breast cancer, and leukemia 1 . Because of the heterogeneity, impact on quality of life, and significant morbidity associated with NF1, there is a considerable need for research into its underlying pathology and noninvasive monitoring of its progression.Systematic study of NF1 in human subjects is a major challenge as the variability in disease presentation between individuals makes it difficult to create an effective longitudinal cohort. Medical imaging is used in the NF1 population to detect and monitor disease phenotypes including optic-pathway glioma 5-7 , plexiform neurofibroma and MPNST, spinal neurofibroma, tibial bowing and scoliosis. Retrospectively collected imaging studies have assessed prevalence and NF1 findings i...

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Evaluation of a free-breathing respiratory-triggered (Navigator) 3-D T1-weighted (T1W) gradient recalled echo sequence (LAVA) for detection of enhancement in cystic and solid renal masses

Cited by 8 publications

References 48 publications

Direct Comparison of Diagnostic Accuracy of Fast Kilovoltage Switching Dual-Energy Computed Tomography and Magnetic Resonance Imaging for Detection of Enhancement in Renal Masses

Direct Comparison of Diagnostic Accuracy of Fast Kilovoltage Switching Dual-Energy Computed Tomography and Magnetic Resonance Imaging for Detection of Enhancement in Renal Masses

Update on MRI of Cystic Renal Masses Including Bosniak Version 2019

Longitudinal phenotype development in a minipig model of neurofibromatosis type 1

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