BACKGROUND AND AIMS: A significant source of man-made radiation is now linked to medical devices especially X-ray imaging based ones like CT scans which expose the body to cumulative ionizing radiation and thus attendant cancer risks. The aim of this study was to determine whether using a combination of Automatic Tube Current Modulation (ATCM) and Automatic Tube Voltage Selection (ATVS) during two-phase whole-body CT (2PWBCT) examinations would reduce the radiation dose while preserving the image quality. PATIENTS AND METHODS: This was a prospective, observational, single-centre study of 127 adult patients who had undergone the 2PWBCT polytraumatic protocol. All were examined on a Somatom Drive scanner (Siemens). The patients were divided into two groups: ATCM only (42 patients) and ATCM +ATVS (85 patients). Patients' arm positions during examination and the examination dose length product (DLP) values were recorded, as well the standard deviations (SD) of the density in reference areas on CT scans for the image quality assessment. The DLP values and image quality in the groups were compared using ANOVA. RESULTS: Mean Total DLP (in mGy*cm): ATCM only: 3337 +/-797, ATCM+ATVS: 3402 +/-830; P=0.674. No effect of arm position (P=0.586). Mean density SD values in reference areas (in HU) in ATCM only: 49 +/-45, 15 +/-6, 9 +/-2, 12 +/-4, 10 +/-3, in ATCM+ATVS: 48 +/-45, 17 +/-6, 11 +/-3, 15 +/-6, 12 +/-4. SD values was higher in ATCM+ATVS group (P<0.001). CONCLUSION: Combination of ATVS and ATCM in polytraumatic 2PWBCT leads to no significant radiation load reduction compared with ATCM only but does lead to a slight degradation of image quality. The radiation load is significantly reduced if the patient has their arms behind the head when scanning, regardless of the activation of ATVS.

• Klíčová slova
• automatic tube current modulation, automatic tube voltage selection, dose length product, polytrauma, whole body CT,
• MeSH
• celotělové zobrazování * metody   MeSH
• dávka záření * MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• počítačová rentgenová tomografie * metody   MeSH
• polytrauma * diagnostické zobrazování   MeSH
• prospektivní studie MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• srovnávací studie MeSH

BACKGROUND: In addition to the diagnostic accuracy of imaging methods, patient-reported satisfaction with imaging methods is important. OBJECTIVE: To report a secondary outcome of the prospective international multicenter Imaging Study in Advanced ovArian Cancer (ISAAC Study), detailing patients' experience with abdomino-pelvic ultrasound, whole-body contrast-enhanced computed tomography (CT), and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) for pre-operative ovarian cancer work-up. METHODS: In total, 144 patients with suspected ovarian cancer at four institutions in two countries (Italy, Czech Republic) underwent ultrasound, CT, and WB-DWI/MRI for pre-operative work-up between January 2020 and November 2022. After having undergone all three examinations, the patients filled in a questionnaire evaluating their overall experience and experience in five domains: preparation before the examination, duration of examination, noise during the procedure, radiation load of CT, and surrounding space. Pain perception, examination-related patient-perceived unexpected, unpleasant, or dangerous events ('adverse events'), and preferred method were also noted. RESULTS: Ultrasound was the preferred method by 49% (70/144) of responders, followed by CT (38%, 55/144), and WB-DWI/MRI (13%, 19/144) (p<0.001). The poorest experience in all domains was reported for WB-DWI/MRI, which was also associated with the largest number of patients who reported adverse events (eg, dyspnea). Patients reported higher levels of pain during the ultrasound examination than during CT and WB-DWI/MRI (p<0.001): 78% (112/144) reported no pain or mild pain, 19% (27/144) moderate pain, and 3% (5/144) reported severe pain (pain score >7 of 10) during the ultrasound examination. We did not identify any factors related to patients' preferred method. CONCLUSION: Ultrasound was the imaging method preferred by most patients despite being associated with more pain during the examination in comparison with CT and WB-DWI/MRI. TRIAL REGISTRATION NUMBER: NCT03808792.

• Klíčová slova
• Cross-Sectional Studies, Ovarian Cancer, Preoperative Care,
• MeSH
• celotělové zobrazování metody   MeSH
• difuzní magnetická rezonance * metody   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory vaječníků * diagnostické zobrazování   patologie   MeSH
• počítačová rentgenová tomografie * metody   MeSH
• předoperační péče metody   MeSH
• prospektivní studie MeSH
• průřezové studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• spokojenost pacientů * MeSH
• staging nádorů MeSH
• ultrasonografie * metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

AIM: Staging of head and neck tumors is one of the most difficult tasks in imaging techniques, due to the very complicated head and neck anatomy and serious problems with the differentiation of reactive enlarged lymph nodes and lymph nodes involved with metastases. The aim of the study was to evaluate the validity of the whole-body approach in the assessment of head and neck malignancies using (18)F-FDG-PET/CT. MATERIALS AND METHODS: The analysis of a group of 1750 consecutive whole-body procedures in all indications of (18)F-FDG-PET/CT was made according to: the presence of orofacial tumors; their histology; findings concerning the spread outside head and neck region; and findings concerning the primary staging or restaging. The examinations of head and neck tumors were performed after intravenous application of the (18)F-FDG and its accumulation for one hour. Drinking and speaking is restricted during this accumulation to prevent artificial muscle (18)F-FDG uptake and to minimize false positive findings. In our hospital, high resolution PET is followed by the sub-millimeter isotropic acquisition of CT data after intravenous application of an iodinated contrast material. The acquisitions of head and neck region and trunk are performed separately to obtain optimal resolution in both regions. RESULTS: 105 examinations of the orofacial tumors were performed on 87 patients in a group of 1750 consecutive PET/CT examinations. The ratio between primary staging and restaging was 3:7. The most frequent indications were carcinomas of the tongue (19 examinations) and carcinomas of the salivary glands (19 examinations). The metastatic spread of the tumor outside the region of the head and neck was noted in 12 cases. CONCLUSION: Our findings of distant metastases confirmed the importance of the use of whole-body PET/CT in this indication.

• MeSH
• celotělové zobrazování metody   MeSH
• fluorodeoxyglukosa F18 * MeSH
• lidé MeSH
• nádory hlavy a krku diagnóza   MeSH
• počítačová rentgenová tomografie metody   MeSH
• pozitronová emisní tomografie metody   MeSH
• radiofarmaka MeSH
• reprodukovatelnost výsledků MeSH
• senzitivita a specificita MeSH
• subtrakční technika * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• fluorodeoxyglukosa F18 * MeSH
• radiofarmaka MeSH

PURPOSE OF THE STUDY The purpose of this study was to assess the available information on patients with a whole-body CT and to ascertain whether the number of examinations could be reduced. MATERIAL AND METHODS This retrospective study included all patients who underwent a whole-body CT in the University Hospital Olomouc during a period of one year. Epidemiologic data of patients and information about the trauma and injuries suffered were collected. The injuries were assessed using the Abbreviated Injury Scale and the Injury Severity Score and classified as high- and low-energy injuries. These two groups were subsequently compared. RESULTS A total of 338 patients were examined, of whom 75% were male and the median age of all patients was 48 years. The most frequent causes of trauma were road accidents in 53% and falls from height in 25%. Ninety-one percent of examined patients were admitted to hospital, 42% underwent a surgery and 3% died. The average ISS was 10.7 and the severity of injury increased with age (p = 0.01). The patients after an attempted suicide and those after motorbike and bike accidents had the highest ISS observed. A higher ISS was detected more often in high-energy traumas than in low-energy traumas (p = 0.002). A completely negative polytrauma CT scan finding was observed in 5 patients with low-energy trauma and in 9 patients with high-energy trauma. CONCLUSIONS High-energy injuries were shown to be associated with higher severity as well as more negative CT scans than lowenergy ones. Bearing in mind that a whole-body CT scan is an extensive examination in which relatively high doses of radiation are used, it should always be considered whether a selective CT of fewer body parts would not be sufficient for the diagnosis. Key words: abbreviated injury scale, injury severity score, multiple trauma.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• lidské tělo * MeSH
• počítačová rentgenová tomografie MeSH
• polytrauma * diagnostické zobrazování   epidemiologie   MeSH
• retrospektivní studie MeSH
• skóre závažnosti úrazu MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

18F-FDG PET/MRI might be the diagnostic method of choice for Hodgkin lymphoma patients, as it combines significant metabolic information from PET with excellent soft-tissue contrast from MRI and avoids radiation exposure from CT. However, a major issue is longer examination times than for PET/CT, especially for younger children needing anesthesia. Thus, a targeted selection of suitable whole-body MRI sequences is important to optimize the PET/MRI workflow. Methods: The initial PET/MRI scans of 84 EuroNet-PHL-C2 study patients from 13 international PET centers were evaluated. In each available MRI sequence, 5 PET-positive lymph nodes were assessed. If extranodal involvement occurred, 2 splenic lesions, 2 skeletal lesions, and 2 lung lesions were also assessed. A detection rate was calculated dividing the number of visible, anatomically assignable, and measurable lesions in the respective MRI sequence by the total number of lesions. Results: Relaxation time-weighted (T2w) transverse sequences with fat saturation (fs) yielded the best result, with detection rates of 95% for nodal lesions, 62% for splenic lesions, 94% for skeletal lesions, and 83% for lung lesions, followed by T2w transverse sequences without fs (86%, 49%, 16%, and 59%, respectively) and longitudinal relaxation time-weighted contrast-enhanced transverse sequences with fs (74%, 35%, 57%, and 55%, respectively). Conclusion: T2w transverse sequences with fs yielded the highest detection rates and are well suited for accurate whole-body PET/MRI in lymphoma patients. There is no evidence to recommend the use of contrast agents.

• Klíčová slova
• Hodgkin lymphoma, MRI sequences, PET/MRI, whole-body imaging,
• MeSH
• celotělové zobrazování metody   MeSH
• difuzní magnetická rezonance metody   MeSH
• dítě MeSH
• fluorodeoxyglukosa F18 MeSH
• Hodgkinova nemoc * diagnostické zobrazování   patologie   MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• nemoci kostí * MeSH
• PET/CT MeSH
• pozitronová emisní tomografie metody   MeSH
• průběh práce MeSH
• radiofarmaka MeSH
• staging nádorů MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• fluorodeoxyglukosa F18 MeSH
• radiofarmaka MeSH

BACKGROUND: Estimating volumes and masses of total body components is important for the study and treatment monitoring of nutrition and nutrition-related disorders, cancer, joint replacement, energy-expenditure and exercise physiology. While several equations have been offered for estimating total body components from MRI slices, no reliable and tested method exists for CT scans. For the first time, body composition data was derived from 41 high-resolution whole-body CT scans. From these data, we defined equations for estimating volumes and masses of total body AT and LT from corresponding tissue areas measured in selected CT scan slices. METHODS: We present a new semi-automatic approach to defining the density cutoff between adipose tissue (AT) and lean tissue (LT) in such material. An intra-class correlation coefficient (ICC) was used to validate the method. The equations for estimating the whole-body composition volume and mass from areas measured in selected slices were modeled with ordinary least squares (OLS) linear regressions and support vector machine regression (SVMR). RESULTS AND DISCUSSION: The best predictive equation for total body AT volume was based on the AT area of a single slice located between the 4th and 5th lumbar vertebrae (L4-L5) and produced lower prediction errors (|PE| = 1.86 liters, %PE = 8.77) than previous equations also based on CT scans. The LT area of the mid-thigh provided the lowest prediction errors (|PE| = 2.52 liters, %PE = 7.08) for estimating whole-body LT volume. We also present equations to predict total body AT and LT masses from a slice located at L4-L5 that resulted in reduced error compared with the previously published equations based on CT scans. The multislice SVMR predictor gave the theoretical upper limit for prediction precision of volumes and cross-validated the results.

• Klíčová slova
• Adipose tissue, Body composition, Lean tissue, Single slices, Volume and mass estimation, Whole-body CT scans,
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: To compare the performance of transvaginal and transabdominal ultrasound with that of the first-line staging method (contrast-enhanced computed tomography (CT)) and a novel technique, whole-body magnetic resonance imaging with diffusion-weighted sequence (WB-DWI/MRI), in the assessment of peritoneal involvement (carcinomatosis), lymph-node staging and prediction of non-resectability in patients with suspected ovarian cancer. METHODS: Between March 2016 and October 2017, all consecutive patients with suspicion of ovarian cancer and surgery planned at a gynecological oncology center underwent preoperative staging and prediction of non-resectability with ultrasound, CT and WB-DWI/MRI. The evaluation followed a single, predefined protocol, assessing peritoneal spread at 19 sites and lymph-node metastasis at eight sites. The prediction of non-resectability was based on abdominal markers. Findings were compared to the reference standard (surgical findings and outcome and histopathological evaluation). RESULTS: Sixty-seven patients with confirmed ovarian cancer were analyzed. Among them, 51 (76%) had advanced-stage and 16 (24%) had early-stage ovarian cancer. Diagnostic laparoscopy only was performed in 16% (11/67) of the cases and laparotomy in 84% (56/67), with no residual disease at the end of surgery in 68% (38/56), residual disease ≤ 1 cm in 16% (9/56) and residual disease > 1 cm in 16% (9/56). Ultrasound and WB-DWI/MRI performed better than did CT in the assessment of overall peritoneal carcinomatosis (area under the receiver-operating-characteristics curve (AUC), 0.87, 0.86 and 0.77, respectively). Ultrasound was not inferior to CT (P = 0.002). For assessment of retroperitoneal lymph-node staging (AUC, 0.72-0.76) and prediction of non-resectability in the abdomen (AUC, 0.74-0.80), all three methods performed similarly. In general, ultrasound had higher or identical specificity to WB-DWI/MRI and CT at each of the 19 peritoneal sites evaluated, but lower or equal sensitivity in the abdomen. Compared with WB-DWI/MRI and CT, transvaginal ultrasound had higher accuracy (94% vs 91% and 85%, respectively) and sensitivity (94% vs 91% and 89%, respectively) in the detection of carcinomatosis in the pelvis. Better accuracy and sensitivity of ultrasound (93% and 100%) than WB-DWI/MRI (83% and 75%) and CT (84% and 88%) in the evaluation of deep rectosigmoid wall infiltration, in particular, supports the potential role of ultrasound in planning rectosigmoid resection. In contrast, for the bowel serosal and mesenterial assessment, abdominal ultrasound had the lowest accuracy (70%, 78% and 79%, respectively) and sensitivity (42%, 65% and 65%, respectively). CONCLUSIONS: This is the first prospective study to document that, in experienced hands, ultrasound may be an alternative to WB-DWI/MRI and CT in ovarian cancer staging, including peritoneal and lymph-node evaluation and prediction of non-resectability based on abdominal markers of non-resectability. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

• Klíčová slova
• abdominal cavity, computed tomography, laparoscopy, laparotomy, lymph node, magnetic resonance imaging, ovarian neoplasm, pelvis, ultrasonography,
• MeSH
• celotělové zobrazování statistika a číselné údaje   MeSH
• difuzní magnetická rezonance statistika a číselné údaje   MeSH
• dospělí MeSH
• epiteliální ovariální karcinom diagnostické zobrazování   patologie   MeSH
• invazivní růst nádoru MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfatické uzliny patologie   MeSH
• magnetická rezonanční tomografie statistika a číselné údaje   MeSH
• nádory vaječníků diagnostické zobrazování   patologie   MeSH
• peritoneální nádory diagnostické zobrazování   patologie   MeSH
• prospektivní studie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The aim of the paper is to recall the invention of whole body stereotactic system employed under clinical conditions after previous model trials. Its prospectives have been overshadowed by the development of sophisticated modern navigation technique.

• MeSH
• celotělové zobrazování dějiny   MeSH
• dějiny 20. století MeSH
• neuronavigace dějiny   MeSH
• počítačová rentgenová tomografie dějiny   MeSH
• stereotaktické techniky dějiny   MeSH
• Check Tag
• dějiny 20. století MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• historické články MeSH

BACKGROUND: Morphology highlighted by diffusion weighted imaging (DWI) is the basis of whole-body MRI (wbMRI). The aim of this study was to analyze current knowledge on the diagnostic performance of wbMRI in the pretreatment staging of patients with lymphoma. METHODS: A search for original articles reporting the diagnostic performance (sensitivity, specificity) of pretreatment (first staging or staging in relapsed patients after complete remission) wbMRI in nodal and extranodal involvement by extracranial lymphoma and the agreement of stage by the Cotswolds-modified Ann Arbor classification in adult patients compared to the reference standard (PET/CT or enhanced reference standard) was conducted in PubMed, EMBASE, Cochrane Library, ClinicalTrials.gov. RESULTS: Altogether 15 studies with 519 patients were included in the meta-analysis. The pooled sensitivity and specificity for nodal involvement were 0.93 (95% CI: 0.90 to 0.96) and 0.99 (95% CI: 0.98 to 1.00). For nodal staging, most studies used the size criterion of 10 mm in the short diameter (n=10) and the absence of prominent fatty hilum (n=4). Restricted diffusion on diffusion-weighted imaging as a sign of nodal involvement was either not used (n=5), used for detection (n=4), semi-quantitatively (n=4), or quantitatively (n=1). Only one study (7) relied solely on restricted diffusion as the main criterion for nodal involvement. The pooled sensitivity and specificity for extranodal involvement were 0.89 (95% CI: 0.79 to 0.98) and 0.99 (95% CI: 0.99 to 1.00). Seven studies considered diffuse splenic involvement when its long or vertical axis was greater than 13 cm regardless of the patient's physiognomy. The pooled agreement in staging (Cohen's kappa) was almost perfect (0.90, 95% CI: 0.84 to 0.95). DISCUSSION: The sensitivity and specificity of wbMRI in the assessment of the nodal and extranodal involvement by lymphoma is high. The agreement of wbMRI with the reference standard is almost perfect.

• Klíčová slova
• Lymphoma, PET/CT, agreement, meta-analysis, staging, whole-body MRI (wbMRI),
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: Recent investigations have evaluated the influence of body composition on long bones in order to overcome the limits of body mass (BM) estimation methods and eventually lead to studying nutrition in past populations. Knowing how fat mass (FM) and fat-free mass (FFM) impact the skeleton would also enhance the understanding of mobility, activity, and locomotion derived from bone architecture. We investigated the relationship between BM and composition, and the architecture of the entire tibial and femoral diaphyses in an adult sample representative of a wide range of variation in age, BM, and composition. MATERIALS AND METHODS: Body composition was measured directly from 78 whole-body CT scans for which the age, sex, BM, and stature were recorded. The entire diaphyseal thickness, volume, curvature, and cross-sectional geometry parameters of both the femur and tibia were numerically extracted. RESULTS: FM correlates with large portions of the femoral thickness in females only. FFM correlates with the femoral diaphysis in males but not in females. FFM correlates with the tibia architecture in both sexes, while FM is correlated in males exclusively. DISCUSSION: BM and body components influence the architecture of the diaphysis of lower limb long bones in sex-specific patterns that are mostly reflected in their thickness and can be recorded, in some cases, for their strength, rigidity, and volume. Our results suggest that (1) long bone diaphyses should be thoroughly studied, as a whole, when possible; and (2) BM and body components should be accounted for when deriving activity, mobility, or locomotion patterns from cortical bone.

• Klíčová slova
• cortical bone, cross-sectional geometry, femur, thickness, tibia,
• MeSH
• anatomie průřezová MeSH
• dospělí MeSH
• femur anatomie a histologie   diagnostické zobrazování   MeSH
• kortikální kost anatomie a histologie   diagnostické zobrazování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• složení těla fyziologie   MeSH
• tělesná hmotnost fyziologie   MeSH
• tibie anatomie a histologie   diagnostické zobrazování   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH