Diffusion weighted imaging: have we found the 'Holy Grail' of diagnostic imaging or is it still a game of numbers?
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Brain↗
Biomedical subjects
Andreas M Herneth
Publications and source records attributed to Andreas M Herneth.
Apparent diffusion coefficient: a quantitative parameter for in vivo tumor characterization.
PURPOSE: The purpose of the this study was to evaluate the potential of diffusion weighted imaging (DWI) to distinguish different tissue compartments in early, intermediate and advanced tumor stages. MATERIALS AND METHODS: Twenty-two male mice were induced with squamous cell tumor (SCCVII) and scanned with a clinical 1.5 T scanner. T1-SE, T2-FSE, diffusion weighted Line-Scan-MRI and contrast enhanced T1-SE were obtained from mice with early (tumor volume 10-100 mm(3)), intermediate (200-600 mm(3)), advanced tumors (600-1000 mm(3)) and tumor necrosis (>1500 mm(3)). The apparent diffusion coefficient (ADC) of different tumor compartments was calculated offline with a pixel-by-pixel method. The animals were sacrificed immediately after scanning and histopathologic correlation was performed. RESULTS: In early stages of tumor development, tumors appeared homogeneous on diffusion weighted images with an ADC of 0.64+/-0.06 x 10(-3) mm(2)/s. With tumor progression the ADC in the rim areas of tumor increased significantly (intermediate stage: 0.70+/-0.11 x 10(-3) mm(2)/s; advanced stage: 0.88+/-0.11 x 10(-3) mm(2)/s; tumor necrosis 1.03+/-0.06 x 10(-3) mm(2)/s), whereas the ADC in viable tumor remained constant. Histologically the areas with an increased ADC correlated well with areas of necrosis (reduced cell density). CONCLUSION: The ADC is a non-invasive technique to monitor changes in the biological structure of tumor tissue during tumor progression. Thus, DWI is a potential diagnostic tool for in-vivo tissue characterization.
Animals↗
Four-channel multidetector CT in facial fractures: do we need 2 x 0.5 mm collimation?
OBJECTIVE: Our aim was to optimize acquisition protocols and multiplanar reformation algorithms for the evaluation of facial fractures using multidetector CT (MDCT) and to determine whether 2 x 0.5 mm collimation is necessary. MATERIALS AND METHODS: A cadaveric head with artificial blunt facial trauma was examined using a four-channel MDCT scanner. The influence of acquisition parameters (collimation, 2 x 0.5 mm, 4 x 1 mm, 4 x 2.5 mm; tube current, 120 mAs, 90 mAs, 60 mAs), image reconstruction algorithms (standard vs ultra-high-resolution modes; reconstructed slice thicknesses, 0.5 mm, 1 mm, 3 mm; increment, 0.3 mm, 0.6 mm, 1.5 mm), and reformation algorithms (slice thicknesses, 0.5 mm, 1 mm, 3 mm; overlap, 0.5 mm, 1 mm, 3 mm) on detectability of facial fractures in multiplanar reformations with MDCT was analyzed. RESULTS: Fracture detection was significantly higher with thin multiplanar reformations (0.5 and 0.5 mm, 1 and 0.5 mm, and 1 and 1 mm) (p < or = 0.014) acquired with 2 x 0.5 mm collimation (p < or = 0.046) in ultra-high-resolution mode (p < 0.0005) with 120 mAs (p < or = 0.025). Interobserver variability showed very good agreement (kappa > or = 0.942). Non-ultra-high-resolution mode, lower milliampere-seconds, and thick multiplanar reformations (3 and 0.5 mm, 3 and 1 mm, and 3 and 0.5 mm) showed significantly decreased fracture detectability. CONCLUSION: Although thin multiplanar reformations obtained from thin collimation (2 x 0.5 mm) are statistically superior for the detection of subtle fractures, 4 x 1 mm collimation is sufficient for routine diagnostic evaluation. Ultra-high-resolution mode with 120 mAs is mandatory for detection of clinically relevant fractures.
Aged↗
Line scan diffusion imaging of the spine.
BACKGROUND AND PURPOSE: Recent findings suggest that diffusion-weighted imaging might be an important adjunct to the diagnostic workup of disease processes in the spine, but physiological motion and the challenging magnetic environment make it difficult to perform reliable quantitative diffusion measurements. Multi-section line scan diffusion imaging of the spine was implemented and evaluated to provide quantitative diffusion measurements of vertebral bodies and intervertebral disks. METHODS: Line scan diffusion imaging of 12 healthy study participants and three patients with benign vertebral compression fractures was performed to assess the potential of line scan diffusion imaging of the spinal column. In a subgroup of six participants, multiple b-value (5-3005 s/mm(2)) images were obtained to test for multi-exponential signal decay. RESULTS: All images were diagnostic and of high quality. Mean diffusion values were (230 +/- 83) x 10(-6) mm(2)/s in the vertebral bodies, (1645 +/- 213) x 10(-6) mm(2)/s in the nuclei pulposi, (837 +/- 318) x 10(-6) mm(2)/s in the annuli fibrosi and ranged from 1019 x 10(-6) mm(2)/s to 1972 x 10(-6) mm(2)/s in benign compression fractures. The mean relative intra-participant variation of mean diffusivity among different vertebral segments (T10-L5) was 2.97%, whereas the relative difference in mean diffusivity among participants was 7.41% (P <.0001). The estimated measurement precision was <2%. A bi-exponential diffusion attenuation was found only in vertebral bodies. CONCLUSION: Line scan diffusion imaging is a robust and reliable method for imaging the spinal column. It does not suffer as strongly from susceptibility artifacts as does echo-planar imaging and is less susceptible to patient motion than are other multi-shot techniques. The different contributions from the water and fat fractions need to be considered in diffusion-weighted imaging of the vertebral bodies.
Adult↗
Imaging articular cartilage defects in the ankle joint with 3D fat-suppressed echo planar imaging: comparison with conventional 3D fat-suppressed gradient echo imaging.
PURPOSE: To shorten the examination time for articular cartilage imaging, using a recently developed three-dimensional (3D) multishot echo planar imaging (EPI) sequence with fat saturated (FS), compared to a conventional 3D fat-saturated spoiled gradient echo sequence (3D FS GRE). MATERIAL AND METHODS: There were 32 consecutive patients with ankle joint disorders who underwent magnetic resonance imaging (MRI) in a 1.0-T unit. Hyaline cartilage was imaged with a 3D FS EPI sequence and a 3D FS GRE sequence. Image assessment criteria included lesion conspicuity, contrast between different types of normal tissue, and image artifacts. In addition, contrast-to-noise ratios (CNRs) of cartilage vs. joint fluid and bone marrow were measured. RESULTS: The 3D FS EPI sequence provided a high CNR between cartilage and subchondral bone, similar to that of the 3D FS GRE sequence. The CNR between cartilage and effusion was significantly lower on the 3D EPI sequence due to the higher signal intensity of fluid. Both sequences were equal in lesion detection ability. The image quality of the 3D FS GRE sequence was slightly higher than that of the 3D FS EPI, but the difference was not statistically significant. CONCLUSION: We conclude that the 3D FS EPI sequence is comparable to the 3D FS GRE sequence in the detection of cartilage lesions, with the additional advantage of reduction in scan time by a factor of 4.
Adolescent↗
Vertebral metastases: assessment with apparent diffusion coefficient.
The authors evaluated the apparent diffusion coefficient (ADC) in the assessment of vertebral metastases and acute vertebral compression fractures in 22 patients with known or suspected vertebral metastases. On the basis of significantly (P <.03) different ADCs, vertebral metastases (0.69 x 10(-3) mm2/sec) and pathologic compression fractures (0.65 x 10(-3) mm2/sec) can be safely distinguished from vertebral bodies (1.66 x 10(-3) mm2/sec) and benign compression fractures (1.62 x 10(-3) mm2/sec). Thus, the use of ADCs may increase the specificity of magnetic resonance imaging in these patients.
Echo-Planar Imaging↗