Lung Metastases from Esophageal Granular Cell Tumor: An Undoubted Criterion for Malignancy

Upper thoracic-spine disc degeneration in patients with cervical pain.

To study the relationship of upper thoracic spine degenerative disc contour changes on MR imaging in patients with neck pain. The relation between upper thoracic and cervical spine degenerative disc disease is not well established.One hundred and fifty-six patients referred with cervical pain were studied. There were 73 women and 77 men with a mean age of 48.6 +/- 14.6 years (range, 19 to 83 years). All MR studies were performed with a large 23-cm FOV covering at least from the body of T4 to the clivus. Discs were coded as normal, protrusion/bulge or extrusion.Degenerative thoracic disc contour changes were observed in 13.4% of patients with cervical pain. T2-3 was the most commonly affecte…

Automatic segmentation of the spine by means of a probabilistic atlas with a special focus on ribs suppression. Preliminary results

Spine is a structure commonly involved in several prevalent diseases. In clinical diagnosis, therapy, and surgical intervention, the identification and segmentation of the vertebral bodies are crucial steps. However, automatic and detailed segmentation of vertebrae is a challenging task, especially due to the proximity of the vertebrae to the corresponding ribs and other structures such as blood vessels. In this study, to overcome these problems, a probabilistic atlas of the spine, including cervical, thoracic and lumbar vertebrae has been built to introduce anatomical knowledge in the segmentation process, aiming to deal with overlapping gray levels and the proximity to other structures. F…

Deterioro cognitivo: clasificación mediante espectroscopia de resonancia magnética de protón y contribución de la imagen convencional

Objetivo Analizar la eficacia diagnostica de la espectroscopia de resonancia magnetica de proton (1H ERM) en pacientes con deterioro cognitivo y establecer la complementariedad de la informacion de imagen de resonancia magnetica (RM) mediante curvas ROC. Material y metodos Se estudian 64 pacientes con deterioro cognitivo, incluyendo enfermedad de Alzheimer (EA) (N = 31), demencia vascular (N = 6), deterioro cognitivo leve (DCL) (N = 9) y depresion mayor (N = 18). Todos se exploraron con RM cerebral y 1H ERM usando dos tiempos de eco (TE, 31 y 136 ms) con volumen unico en la circonvolucion cingular posterior y lobulo temporal derecho. Los metabolitos analizados fueron N-acetilaspartato (NAA)…

Cognitive impairment: classification by 1H magnetic resonance spectroscopy.

1H magnetic resonance spectroscopy (MRS) allows accurate and non-invasive in vivo metabolic study, and is a useful tool for the diagnosis of different forms of dementias. Cognitive impairment pathologies have been almost exclusively studied with MRS by comparison with healthy without a global comparison amongst Alzheimer disease (AD), vascular dementia, mild cognitive impairment (MCI) and major depression patients with cognitive impairment. Whereas decrease of N-acetylaspartate (NAA) and increase myo-Inositol (mI) at different brain locations by 1H MRS are common features of AD, Choline (Cho) alterations have been inconclusive. In our study, 64 patients with cognitive impairment were evalua…

Corpus callosum function in verbal dichotic listening: inferences from a longitudinal follow-up of Relapsing-Remitting Multiple Sclerosis patients.

This study conducted a follow-up of 13 early-onset slightly disabled Relapsing-Remitting Multiple Sclerosis (RRMS) patients within an year, evaluating both CC area measurements in a midsagittal Magnetic Resonance (MR) image, and Dichotic Listening (DL) testing with stop consonant vowel (C-V) syllables. Patients showed a significant progressive loss of posterior CC areas (isthmus and splenium) related to increasing EDSS scores and an enhancing right ear advantage (REA) over time. A significant correlation between posterior CC areas and DL scores emerged in both evaluations, being negative for the right and positive for the left ear. The pattern of correlations suggests that the CC can serve …

Identifying the primary site of origin of MRI brain metastases from lung and breast cancer following a 2D radiomics approach

Detection of brain metastases in patients with undiagnosed primary cancer is unusual but still an existing phenomenon. In these cases, identifying the cancer site of origin is non-feasible by visual examination of magnetic resonance (MR) images. Recently, radiomics has been proposed to analyze differences among classes of visually imperceptible imaging characteristics. In this study we analyzed 46 T1-weighted MR images of brain metastases from 29 patients: 29 of lung and 17 of breast origin. A total of 43 radiomics texture features were extracted from the metastatic lesions. Support vector machine (SVM) and k-nearest neighbors (k-NN) classifiers were implemented to evaluate the classificati…

Metastatic Versus Osteoporotic Vertebral Fractures on MRI: A Blinded, Multicenter, and Multispecialty Observer Agreement Evaluation.

Background: MRI is assumed to be valid for distinguishing metastatic vertebral fractures (MVFs) from osteoporotic vertebral fractures (OVFs). This study assessed (1) concordance between the image-based diagnosis of MVF versus OVF and the reference (biopsy or follow-up of >6 months), (2) interobserver and intraobserver agreement on key imaging findings and the diagnosis of MVF versus OVF, and (3) whether disclosing a patient’s history of cancer leads to variations in diagnosis, concordance, or agreement. Patients and Methods: This retrospective cohort study included clinical data and imaging from 203 patients with confirmed MVF or OVF provided to 25 clinicians (neurosurgeons, radiologists…

Malignant Peripheral Nerve Sheath Tumor With Osseous Heterologous Differentiation in Uncommon Locations (Heart and Retropharynx)

We report two cases of malignant peripheral nerve sheath tumor (MPNST) in an uncommon location (heart and retropharynx) both with divergent osseous heterologous differentiation. We present the pathological and immunohistochemical studies that confirmed the neurogenic origin. The histopathology of the tumor arising in the retropharynx showed a transition from a neurofibroma to MPNST, making this a new report of an MPNST arising from a plexiform neurofibroma without neurofibromatosis. Primary cardiac MPNST with osseous differentiation has never been reported before. In conclusion, the histology of MPNSTs is very heterogeneous, showing no specific diagnostic immunoprofile or genetic alteration…

Ki-67 immunoexpression and radiological assessment of necrosis improves accuracy of conventional and modified core biopsy systems in predicting the final grade assigned to adult-soft tissue sarcomas. An international collaborative study

Based on the French Federation Nationale des Centers de Lutte Contre le Cancer (FNCLCC) grading system, this study assesses the accuracy of conventional and modified core biopsy (CB) systems in predicting the final grade (low vs high) assigned to the resected specimen. Substituting Ki-67 immunoexpression for mitotic count, and radiological for histological assessment of necrosis, we used two modified FNCLCC CB grading systems: (1) Ki-67 immunoexpression alone, and (2) Ki-67 plus radiological assessment of necrosis. We graded 199 soft tissue sarcomas (STS) from nine centers, and compared the results for the conventional (obtained from local histopathology reports) and modified CB systems wit…

A radiomics evaluation of 2D and 3D MRI texture features to classify brain metastases from lung cancer and melanoma

[EN] Brain metastases are occasionally detected before diagnosing their primary site of origin. In these cases, simple visual examination of medical images of the metastases is not enough to identify the primary cancer, so an extensive evaluation is needed. To avoid this procedure, a radiomics approach on magnetic resonance (MR) images of the metastatic lesions is proposed to classify two of the most frequent origins (lung cancer and melanoma). In this study, 50 T1-weighted MR images of brain metastases from 30 patients were analyzed: 27 of lung cancer and 23 of melanoma origin. A total of 43 statistical texture features were extracted from the segmented lesions in 2D and 3D. Five predictiv…

Comment on “Computer-Extracted Texture Features to Distinguish Cerebral Radionecrosis from Recurrent Brain Tumors on Multiparametric MRI: A Feasibility Study”

We have read with great interest the article published by Tiwari et al, “Computer-Extracted Texture Features to Distinguish Cerebral Radionecrosis from Recurrent Brain Tumors on Multiparametric MRI: A Feasibility Study.”[1][1] In their article, they refer to our work regarding brain metastasis

Automatic segmentation of the spine by means of a probabilistic atlas with a special focus on ribs suppression

[EN] Purpose: The development of automatic and reliable algorithms for the detection and segmentation of the vertebrae are of great importance prior to any diagnostic task. However, an important problem found to accurately segment the vertebrae is the presence of the ribs in the thoracic region. To overcome this problem, a probabilistic atlas of the spine has been developed dealing with the proximity of other structures, with a special focus on ribs suppression. Methods: The data sets used consist of Computed Tomography images corresponding to 21 patients suffering from spinal metastases. Two methods have been combined to obtain the final result: firstly, an initial segmentation is performe…

Agreement in metastatic spinal cord compression

Background: Metastatic epidural spinal cord compression (ESCC) is a devastating medical emergency. The purpose of this study was to determine the reliability of the 6-point ESCC scoring system and the identification of the spinal level presenting ESCC. Methods: Clinical data and imaging from 90 patients with biopsy-proven spinal metastases were provided to 83 specialists from 44 hospitals. The spinal levels presenting metastases and the ESCC scores for each case were calculated twice by each clinician, with a minimum of 6 weeks' interval. Clinicians were blinded to assessments made by other specialists and their own previous assessment. Fleiss kappa (κ) statistic was used to assess intraobs…

Magnetic resonance myelography evaluation of the lumbar spine end plates and intervertebral disks.

Purpose: To evaluate the value of magnetic resonance (MR) myelography in the evaluation of intervertebral disk and end‐plate degenerative changes in the lumbar spine.Material and Methods: Conventional MR and MR myelography examinations were performed in 150 consecutive patients (69 F and 81 M, mean age 45±15 years, range 18–89). Sagittal T1 and T2‐weighted TSE images were compared to MR myelography obtained with a multishot‐TSE‐T2‐weighted sequence (4000/250/fat suppression). Coronal, sagittal, and both oblique MR myelography projections were obtained. Image analysis was carried out independently by two radiologists who categorized lumbar disks into normal, degenerated, or edematous; and ve…

Validation procedures in radiological diagnostic models. Neural network and logistic regression

The objective of this paper is to compare the performance of two predictive radiological models, logistic regression (LR) and neural network (NN), with five different resampling methods. One hundred and sixty-seven patients with proven calvarial lesions as the only known disease were enrolled. Clinical and CT data were used for LR and NN models. Both models were developed with cross validation, leave-one-out and three different bootstrap algorithms. The final results of each model were compared with error rate and the area under receiver operating characteristic curves (Az). The neural network obtained statistically higher Az than LR with cross validation. The remaining resampling validatio…

Support vector machine classification of brain metastasis and radiation necrosis based on texture analysis in MRI

Purpose To develop a classification model using texture features and support vector machine in contrast-enhanced T1-weighted images to differentiate between brain metastasis and radiation necrosis. Methods Texture features were extracted from 115 lesions: 32 of them previously diagnosed as radiation necrosis, 23 as radiation-treated metastasis and 60 untreated metastases; including a total of 179 features derived from six texture analysis methods. A feature selection technique based on support vector machine was used to obtain a subset of features that provide optimal performance. Results The highest classification accuracy evaluated over test sets was achieved with a subset of ten features…