MRCP in patient care: a prospective survey of gastroenterologists.

Objective: MRCP is increasingly used to evaluate pancreaticobiliary disease, yet its effect on patient care is unknown. The purpose of this study was to measure the effect of MRCP on referring physicians' initial diagnoses, the physicians' confidence in their diagnoses, and the influence of MRCP results on clinical management.

Subjects And Methods: We prospectively surveyed gastroenterologists who referred patients for nonurgent MRCP for pancreaticobiliary evaluation.

Pancreatic cancer: utility of dynamic contrast-enhanced MR imaging in assessment of antiangiogenic therapy.

Purpose: To prospectively evaluate the utility of dynamic contrast material-enhanced magnetic resonance (MR) imaging in predicting the response of locally advanced pancreatic cancer to combined chemotherapy and antiangiogenic therapy.

Materials And Methods: This prospective, institutional review board-approved, HIPAA-compliant study with informed consent assessed dynamic contrast-enhanced MR imaging in 11 patients (mean age, 54.3 years; six men and five women) with locally invasive pancreatic cancer before and 28 days after combined chemotherapy and antiangiogenic therapy.

Diagnosis of chronic pancreatitis by using apparent diffusion coefficient measurements at 3.0-T MR following secretin stimulation.

Purpose: To prospectively measure pancreatic apparent diffusion coefficient (ADC) before and after secretin administration in subjects with and without chronic pancreatitis (CP) who underwent magnetic resonance (MR) cholangiopancreatography with diffusion-weighted (DW) imaging at 3.0 T.

Materials And Methods: Institutional review board approval of this HIPAA-compliant study was obtained.

Assessment of chronic pancreatitis: utility of diffusion-weighted MR imaging with secretin enhancement.

Purpose: To retrospectively measure and compare changes in pancreatic apparent diffusion coefficient (ADC) following secretin administration in patients with and those without chronic pancreatitis (CP) who underwent magnetic resonance (MR) cholangiopancreatography with diffusion-weighted (DW) imaging.

Materials And Methods: This retrospective HIPAA-compliant study was approved by the authors' institutional review board, with waiver of informed consent. Eighty-nine patients were categorized by the referring gastroenterologist as having no CP (n = 37), mild CP (n = 33), or severe CP (n = 19) on the basis of Cambridge criteria and/or clinical course.

MR cholangiopancreatography in children: feasibility, safety, and initial experience.

Background: The indications for MR cholangiopancreatography (MRCP) in children, and its safety and findings, might differ from those in adults and are not well described.

Objective: To investigate the safety, feasibility, and accuracy of MRCP in children.

Materials And Methods: We reviewed all prospective MRCP reports, noting the indication, the use of secretin, endoscopic retrograde cholangiopancreatography (ERCP) findings, and patient outcomes.

Dynamic secretin-enhanced MR cholangiopancreatography.

Secretin causes temporary dilatation of pancreatic ducts, principally by increasing pancreatic exocrine secretions, and thus allows better visualization of the ducts at magnetic resonance (MR) cholangiopancreatography. Secretin-enhanced MR cholangiopancreatography is useful for detection and diagnosis of a variety of congenital, inflammatory, and neoplastic conditions of the pancreas. Although MR cholangiopancreatography without secretin is a reliable method for evaluating the pancreatobiliary ductal system, the authors believe that secretin-enhanced MR cholangiopancreatography gives additional valuable functional and anatomic information about the pancreatic duct and pancreatic excretory capacity.

Use of iodine-123 as a diagnostic tracer for neck and whole-body scanning in patients with well-differentiated thyroid cancer.

Objective: To determine whether 123 I can be used as a safe and effective alternative tracer to 131 I for imaging remnant tissue and for searching for metastatic lesions of well-differentiated thyroid cancer.

Methods: We studied a series of 16 patients (10 women and 6 men; 29 to 73 years of age) who had well-differentiated thyroid cancer and had undergone thyroidectomy and subsequent radioiodine treatment. Diagnostic 10 mCi (either preablation or postablation) were compared with the 5- to 7-day 131 I posttherapy scans (doses, 75 to 200 mCi).

Tumor and infection localization in AIDS patients: Ga-67 and Tl-201 findings.

Examples of Ga-67 and Tl-201 scans in AIDS patients performed at St. Vincent's Hospital and Medical Center of New York are presented. Use of these methods is the adopted approach at this institution in AIDS patients for localizing sites of tumor or infection involvement.

Comparison between 201Tl-chloride and 99Tc(m)-sestamibi SPET brain imaging for differentiating intracranial lymphoma from non-malignant lesions in AIDS patients.

The aim of this study was to compare 201Tl-chloride and 99Tc(m)-sestamibi (MIBI) SPET brain imaging for differentiating brain lymphoma from other intracranial lesions in AIDS patients. Both studies were performed on the same day in 17 AIDS patients with intracranial enhancing lesions on either CT or MRI. Eleven patients underwent brain biopsy and six patients were followed clinically.

Sites of tuberculous involvement in patients with AIDS. Autopsy findings and evaluation of gallium imaging.

The purpose of this study was to review autopsy and gallium scan findings in two different acquired immune deficiency syndrome (AIDS) patient populations who had a confirmed diagnosis of tuberculosis (TB) to identify organs involved and accuracy of clinical diagnosis. The first group was comprised of 29 autopsies between January 1982 and December 1994, including only 18 patients who were diagnosed before death. Organs most commonly involved were the lymph nodes (59%), lungs (56%), spleen (53%), liver (45%), and kidneys (37%).

Lung-heart ratio in stress thallium myocardial perfusion imaging in patients with a history of a previous pneumonectomy.

Increased TI-201 lung-heart ratio after treadmill exercise or pharmacologic stress is an indicator of left ventricular dysfunction. After pneumonectomy, it is not reliable because of increased pulmonary circulation in the remaining lung. The authors present an example of normal stress TI-201 myocardial perfusion imaging with an increased lung-heart ratio of TI-201 uptake.