BACKGROUND: White light (WL) is the established imaging modality for transurethral resection of bladder tumour (TURBT). Narrow band imaging (NBI) is a promising addition. OBJECTIVES: To compare 12-mo recurrence rates following TURBT using NBI versus WL guidance. DESIGN, SETTING, AND PARTICIPANTS: The Clinical Research Office of the Endourological Society (CROES) conducted a prospective randomised single-blind multicentre study. Patients with primary non-muscle-invasive bladder cancer (NMIBC) were randomly assigned 1:1 to TURBT guided by NBI or WL. INTERVENTION: TURBT for NMIBC using NBI or WL. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Twelve-month recurrence rates were compared by chi-square tests and survival analyses. RESULTS AND LIMITATIONS: Of the 965 patients enrolled in the study, 481 patients underwent WL-assisted TURBT and 484 patients received NBI-assisted TURBT. Of these, 294 and 303 patients, respectively, completed 12-mo follow-up, with recurrence rates of 27.1% and 25.4%, respectively (p=0.585, intention-to-treat [ITT] analysis). In patients at low risk for disease recurrence, recurrence rates at 12 mo were significantly higher in the WL group compared with the NBI group (27.3% vs 5.6%; p=0.002, ITT analysis). Although TURBT took longer on average with NBI plus WL compared with WL alone (38.1 vs 35.0min, p=0.039, ITT; 39.1 vs 35.7min, p=0.047, per protocol [PP] analysis), lesions were significantly more often visible with NBI than with WL (p=0.033). Frequency and severity of adverse events were similar in both treatment groups. Possible limitations were lack of uniformity of surgical resection, data on smoking status, central pathology review, and specific data regarding adjuvant intravesical instillation therapy. CONCLUSIONS: NBI and WL guidance achieved similar overall recurrence rates 12 mo after TURBT in patients with NMIBC. NBI-assisted TURBT significantly reduced the likelihood of disease recurrence in low-risk patients. PATIENT SUMMARY: Use of a narrow band imaging technique might provide greater detection of bladder tumours and subsequent treatment leading to reduced recurrence in low-risk patients.
- Keywords
- Narrow band imaging, Non–muscle-invasive bladder cancer, Transurethral resection of bladder tumour, Tumour recurrence, White light imaging,
- MeSH
- Adult MeSH
- Neoplasm Invasiveness MeSH
- Single-Blind Method MeSH
- Clinical Protocols MeSH
- Middle Aged MeSH
- Humans MeSH
- Neoplasm Recurrence, Local etiology MeSH
- Adolescent MeSH
- Young Adult MeSH
- Urinary Bladder Neoplasms diagnostic imaging pathology surgery MeSH
- Prospective Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Light MeSH
- Narrow Band Imaging * MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Randomized Controlled Trial MeSH
The imaging modality choice depends on the clinical question in hepatocellular carcinoma (HCC); when HCC is suspected, then ultrasound serves as imaging at the first line, followed by computed tomography. When specialized differential dia-gnosis or bio-logical behaviour of HCC is a clinical issue, magnetic resonance imaging with a use of hepatospecific contrast agent or hybrid imaging using positron emission tomography and computed tomography or positron emission tomography and magnetic resonance imaging with the application of 18F-fluorodeoxglucose or 18F-fluorocholine are exploited. In the therapy of HCC, it is possible to use locally destructive methods of interventional radiology, especially radiofrequency ablation or transarterial chemoembolization, or radioembolization, as the case may be.
- Keywords
- computed tomography, hepatocellular carcinoma, hybrid imaging methods, magnetic resonance imaging, positron emission tomography,
- MeSH
- Surgery, Computer-Assisted methods MeSH
- Carcinoma, Hepatocellular diagnostic imaging pathology surgery MeSH
- Catheter Ablation methods MeSH
- Humans MeSH
- Multimodal Imaging methods MeSH
- Liver Neoplasms pathology surgery MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
In the last decade, organoids became a tremendously popular technique in developmental and cancer biology for their high pathophysiological relevance to in vivo models with the advantage of easier manipulation, real-time observation, potential for high-throughput studies, and reduced ethical issues. Among other fundamental biological questions, mammary organoids have helped to reveal mechanisms of mammary epithelial morphogenesis, mammary stem cell potential, regulation of lineage specification, mechanisms of breast cancer invasion or resistance to therapy, and their regulation by stromal microenvironment. To exploit the potential of organoid technology to the fullest, together with optimal organoid culture protocols, visualization of organoid architecture and composition in high resolution in three dimensions (3D) is required. Whole-mount imaging of immunolabeled organoids enables preservation of the 3D cellular context, but conventional confocal microscopy of organoid cultures struggles with the large organoid sample size and relatively long distance from the objective to the organoid due to the 3D extracellular matrix (ECM) that surrounds the organoid. We have overcome these issues by physical separation of single organoids with their immediate stroma from the bulk ECM. Here we provide a detail protocol for the procedure, which entails single organoid collection and droplet-based staining and clearing to allow visualization of organoids in the greatest detail.
- Keywords
- 3D culture, Clearing, Confocal imaging, Microenvironment, Organoid, Staining,
- MeSH
- Staining and Labeling MeSH
- Microscopy, Confocal MeSH
- Humans MeSH
- Organoids * MeSH
- Breast MeSH
- Imaging, Three-Dimensional * methods MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
OBJECTIVE: To create a comprehensive overview of imaging methods for diagnosing pudendal neuralgia. METHODOLOGY: Literature review. CONCLUSION: Pudendal neuralgia is a chronic pain condition that is difficult to diagnose. On average, it takes 5 years from the onset of symptoms to the correct diagnosis. Diagnosis is based on symptoms described by the patient, neuropelveological physical examination, and presence of the 5 Nantes criteria. Imaging methods, especially ultrasound and magnetic resonance imaging of the pudendal nerve, show great promise for a more accurate and faster diagnosis. These methods can assist in diagnosing issues and excluding other pathologies that may cause symptoms.
- Keywords
- chronic pelvic pain, imaging, imaging methods, magnetic resonance, pudendal nerve, pudendal neuralgia,
- MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Pudendal Nerve diagnostic imaging MeSH
- Pudendal Neuralgia * diagnosis diagnostic imaging MeSH
- Ultrasonography MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
OBJECTIVE: The accuracy of phase-contrast magnetic resonance imaging (PC-MRI) measurement is investigated using a computational fluid dynamics (CFD) model with the objective to determine the magnitude of the flow underestimation due to turbulence behind a narrowed valve in a phantom experiment. MATERIALS AND METHODS: An acrylic stationary flow phantom is used with three insertable plates mimicking aortic valvular stenoses of varying degrees. Positive and negative horizontal fluxes are measured at equidistant slices using standard PC-MRI sequences by 1.5T and 3T systems. The CFD model is based on the 3D lattice Boltzmann method (LBM). The experimental and simulated data are compared using the Bland-Altman-derived limits of agreement. Based on the LBM results, the turbulence is quantified and confronted with the level of flow underestimation. RESULTS: LBM gives comparable results to PC-MRI for valves up to moderate stenosis on both field strengths. The flow magnitude through a severely stenotic valve was underestimated due to signal void in the regions of turbulent flow behind the valve, consistently with the level of quantified turbulence intensity. DISCUSSION: Flow measured by PC-MRI is affected by noise and turbulence. LBM can simulate turbulent flow efficiently and accurately, it has therefore the potential to improve clinical interpretation of PC-MRI.
- Keywords
- Aortic valve stenosis, Computational fluid dynamics, Flow phantom, Lattice Boltzmann method, Phase-contrast MRI,
- MeSH
- Aortic Valve * MeSH
- Aortic Valve Stenosis * MeSH
- Phantoms, Imaging MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Blood Flow Velocity MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
The 255th ENMC workshop on Muscle Imaging in Idiopathic Inflammatory myopathies (IIM) aimed at defining recommendations concerning the applicability of muscle imaging in IIM. The workshop comprised of clinicians, researchers and people living with myositis. We aimed to achieve consensus on the following topics: a standardized protocol for the evaluation of muscle images in various types of IIMs; the exact parameters, anatomical localizations and magnetic resonance imaging (MRI) techniques; ultrasound as assessment tool in IIM; assessment methods; the pattern of muscle involvement in IIM subtypes; the application of MRI as biomarker in follow-up studies and clinical trials, and the place of MRI in the evaluation of swallowing difficulty and cardiac manifestations. The following recommendations were formulated: In patients with suspected IIM, muscle imaging is highly recommended to be part of the initial diagnostic workup and baseline assessment. MRI is the preferred imaging modality due to its sensitivity to both oedema and fat accumulation. Ultrasound may be used for suspected IBM. Repeat imaging should be considered if patients do not respond to treatment, if there is ongoing diagnostic uncertainty or there is clinical or laboratory evidence of disease relapse. Quantitative MRI is established as a sensitive biomarker in IBM and could be included as a primary or secondary outcome measure in early phase clinical trials, or as a secondary outcome measure in late phase clinical trials. Finally, a research agenda was drawn up.
- MeSH
- Biomarkers MeSH
- Muscle, Skeletal pathology MeSH
- Humans MeSH
- Magnetic Resonance Imaging methods MeSH
- Myositis * diagnosis MeSH
- Check Tag
- Humans MeSH
- Publication type
- Congress MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Netherlands MeSH
- Names of Substances
- Biomarkers MeSH
PURPOSE: To develop a fat-water imaging method that allows reliable separation of the two tissues, uses established robust reconstruction methods, and requires only one single-echo acquisition. THEORY AND METHODS: The proposed method uses spectrally selective dual-band excitation in combination with CAIPIRINHA to generate separate images of fat and water simultaneously. Spatially selective excitation without cross-contamination is made possible by the use of spatial-spectral pulses. Fat and water images can either be visualized separately, or the fat images can be corrected for chemical shift displacement and, in gradient echo imaging, for chemical shift-related phase discrepancy, and recombined with water images, generating fat-water images free of chemical shift effects. Gradient echo and turbo spin echo sequences were developed based on this Simultaneous Multiple Resonance Frequency imaging (SMURF) approach and their performance was assessed at 3Tesla in imaging of the knee, breasts, and abdomen. RESULTS: The proposed method generated well-separated fat and water images with minimal unaliasing artefacts or cross-excitation, evidenced by the near absence of water signal attributed to the fat image and vice versa. The separation achieved was similar to or better than that using separate acquisitions with water- and fat-saturation or Dixon methods. The recombined fat-water images provided similar image contrast to conventional images, but the chemical shift effects were eliminated. CONCLUSION: Simultaneous Multiple Resonance Frequency imaging is a robust fat-water imaging technique that offers a solution to imaging of body regions with significant amounts of fat.
- Keywords
- Simultaneous Multiple Resonance Frequency (SMURF), chemical shift artefact, dual-band, fat-suppression, fat-water imaging, spatial-spectral pulses,
- MeSH
- Artifacts MeSH
- Diagnostic Tests, Routine MeSH
- Diagnostic Imaging * MeSH
- Magnetic Resonance Imaging MeSH
- Image Processing, Computer-Assisted MeSH
- Adipose Tissue diagnostic imaging MeSH
- Vibration MeSH
- Water * MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Water * MeSH
BACKGROUND: POEMS syndrome is a clinical condition with a very heterogeneous clinical manifestation. Its presentation as well as monitoring is complex and dependent on the clinician's experience. One of the leading presenting symptoms is based on evaluation of skeletal damage with typical osteosclerotic or mixed lesions. AIMS AND METHODS: Our aim was to compare the usefulness of different imaging methods in the diagnostics of POEMS syndrome, such as conventional radiography, densitometry, technetium scintigraphy, PET/CT scan, MRI and angiography on a series of three patients with POEMS syndrome with different clinical manifestations and course of disease. RESULTS: Our series demonstrates different types of skeletal involvement in POEMS syndrome. Although conventional X-ray is the imaging method mostly used for the evaluation, its sensitivity and specificity is low. Under specific conditions, other imaging methods should be considered, giving a more complex outlook of the disease's skeletal involvement. Nevertheless, FDG-PET/CT confirmed its superiority in defining both skeletal lesions as well as the activity of the neoplastic process. CONCLUSIONS: We conclude that the different manifestation of the disease implies the necessity of a complex evaluation of imaging methods in mutual concordance. FDG-PET/CT emerges as the most contributive method for the evaluation of both the extent and activity of the disease.
- MeSH
- Adult MeSH
- Bone and Bones diagnostic imaging pathology MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Multimodal Imaging MeSH
- Osteosclerosis complications diagnosis diagnostic imaging MeSH
- Tomography, X-Ray Computed MeSH
- POEMS Syndrome complications diagnosis MeSH
- Positron-Emission Tomography MeSH
- Aged, 80 and over MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- Research Support, Non-U.S. Gov't MeSH
- Comparative Study MeSH
PURPOSE: The soft tissue imaging in micro-CT remains challenging due to its low intrinsic contrast. The aim of this study was to create a simple staining method omitting the usage of contrast agents for ex vivo soft tissue imaging in micro-CT. MATERIALS AND METHODS: Hearts and lungs from 30 mice were used. Twenty-seven organs were either fixed in 97% or 50% ethanol solution or in a series of ascending ethanol concentrations. Images were acquired after 72, 168 and 336 h on a custom-built micro-CT machine and compared to scans of three native samples. RESULTS: Ethanol provided contrast enhancement in all evaluated fixations. Fixation in 97% ethanol resulted in contrast enhancement after 72 h; however, it caused hardening of the samples. Fixation in 50% ethanol provided contrast enhancement after 336 h, with milder hardening, compared to the 97% ethanol fixation, but the visualization of details was worse. The fixation in a series of ascending ethanol concentrations provided the most satisfactory results; all organs were visualized in great detail without tissue damage. CONCLUSIONS: Simple ethanol fixation improves the tissue contrast enhancement in micro-CT. The best results can be obtained with fixation of the soft tissue samples in a series of ascending ethanol concentrations.
- Keywords
- Ethanol, Heart, Lungs, Mice, Micro-CT,
- MeSH
- Ethanol * MeSH
- Contrast Media * MeSH
- Models, Animal MeSH
- Mice, Inbred C57BL MeSH
- Mice MeSH
- Lung anatomy & histology diagnostic imaging MeSH
- X-Ray Microtomography methods MeSH
- Heart anatomy & histology diagnostic imaging MeSH
- Image Enhancement methods MeSH
- Animals MeSH
- Check Tag
- Male MeSH
- Mice MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Ethanol * MeSH
- Contrast Media * MeSH
BACKGROUND: Narrow band imaging (NBI) is an endoscopic method using filtered wavelengths in detection of microvascular abnormalities associated with preneoplastic and neoplastic changes of the mucosa. The aim of the study is to evaluate the value of NBI endoscopy in the dia-gnosis of laryngeal precancerous and early stages of cancerous lesions and to investigate impact of NBI method in prehistological diagnostics in vivo. MATERIALS AND METHODS: One hundred patients were enrolled in the study and their larynx was investigated using white light HD endoscopy and narrow band imaging between 6/ 2013- 10/ 2014. Indication criteria included chronic laryngitis, hoarseness for more than three weeks or macroscopic laryngeal lesion. Features of mucosal lesions were evaluated by white light endoscopy and afterwards were compared with intra-epithelial papillary capillary loop changes, viewed using NBI endoscopy. Suspicious lesions (leukoplakia, exophytic tumors, recurrent respiratory papillomatosis and/ or malignant type of vascular network by NBI endoscopy) were evaluated by histological analysis, results were compared with prehistological NBI dia-gnosis. RESULTS: Using NBI endoscopy, larger demarcation of pathological mucosal features than in white light visualization were recorded in 32/ 100 (32.0%) lesions, in 4/ 100 (4.0%) cases even new lesions were detected only by NBI endoscopy. 63/ 100 (63.0%) suspected lesions were evaluated histologically - malign changes (carcinoma in situ or invasive carcinoma) were observed in 25/ 63 (39.7%). Prehistological diagnostics of malignant lesions using NBI endoscopy were in agreement with results of histological examination in 23/ 25 (92.0%) cases. The sensitivity of NBI in detecting malignant lesions was 89.3%, specificity of this method was 94.9%. CONCLUSION: NBI endoscopy is a promising optical technique enabling in vivo differentiation of superficial neoplastic lesions. These results suggest endoscopic NBI may be useful in the early detection of laryngeal cancer and precancerous lesions.
- MeSH
- Early Detection of Cancer MeSH
- Laryngoscopy * MeSH
- Humans MeSH
- Laryngeal Neoplasms diagnosis MeSH
- Laryngeal Mucosa blood supply pathology MeSH
- Carcinoma, Squamous Cell diagnosis MeSH
- Narrow Band Imaging * MeSH
- Check Tag
- Humans MeSH
- Publication type
- English Abstract MeSH
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
