Publications by authors named "Andoni P Toms"

Article Synopsis
  • Somatic overgrowth disorders are rare conditions characterized by the abnormal enlargement of specific tissues, often related to the activation of the PI3K-AKT-mTOR signaling pathway, which is also implicated in cancer.
  • Genetic variations can either enhance or inhibit this pathway, leading to excessive cell growth in particular areas, noted in disorders like CLOVES syndrome and Klippel-Trenaunay syndrome.
  • Neurofibromatosis type 1 (NF1) involves faulty regulation of this pathway due to mutations in the NF1 gene, resulting in a range of growth abnormalities that can resemble other PIK3CA-related conditions, prompting a focus on their shared genetic and radiological features.
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Objectives: The purpose of this agreement was to establish evidence-based consensus statements on imaging of distal radioulnar joint (DRUJ) instability and triangular fibrocartilage complex (TFCC) injuries by an expert group using the Delphi technique.

Methods: Nineteen hand surgeons developed a preliminary list of questions on DRUJ instability and TFCC injuries. Radiologists created statements based on the literature and the authors' clinical experience.

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Objectives: Rotational malalignment of knee replacements as measured on CT is understood to be associated with poor outcomes. The aim of this study is to measure the inter-rater and intra-rater reliability of measures of femoral and tibial version in the native arthritic knee and postoperative TKR component position using CT.

Methods: Eighty patients underwent CT of the knee before and after total knee replacement.

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Background: Stress fractures are a common and potentially debilitating overuse injury to bone and occur frequently among military recruits and athletes. Recovery from a lower body stress fracture typically requires several weeks of physical rehabilitation. Teriparatide, a recombinant form of the bioactive portion of parathyroid hormone (1-34 amino acids), is used to treat osteoporosis, prevent osteoporotic fractures, and enhance fracture healing due to its net anabolic effect on bone.

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Objectives: The purpose of this agreement was to establish evidence-based consensus statements on imaging of scapholunate joint (SLJ) instability by an expert group using the Delphi technique.

Methods: Nineteen hand surgeons developed a preliminary list of questions on SLJ instability. Radiologists created statements based on the literature and the authors' clinical experience.

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Objective: There is no validated radiographic measurement to diagnose prosthetic complication(s) following total ankle replacements (TARs) although a number of angular and linear measurements, used to define the TAR position on postoperative radiographs, have been recommended to detect prosthetic loosening. The aim of this study was to test the intra- and interobserver reliability of these measurements.

Materials And Methods: This is a prospective study embedded within a multicentre cohort study.

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A standard relationship of the median nerve to neighboring tendons in the carpal tunnel has been described, but descriptions of normal variations are limited. The aim of this study is to describe the variation in position of the median nerve within the carpal tunnel and the variability in relation to adjacent tendons on clinical MR studies. A retrospective study was performed, analyzing 37 wrist MR examinations performed on a 3T MR machine.

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Introduction: Metal-on-metal (MoM) total hip arthroplasties (THAs) have been linked with increased incidence of pseudotumours and revision rate. magnetic resonance imaging (MRI) is useful in diagnosing adverse reaction to metal debris (ARMD) disease but it is not known if MRI findings correlate with cup position.

Patients And Methods: From a cohort of 79 MoM THA, 34 MRI studies were available.

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Aim: Image-guided cervical nerve root injections can cause serious complications including spinal cord infarction. This risk may be increased in patients with carotid stenosis who develop collateral arteries. The aim of this study is to describe the prevalence, and anatomical location, of arterial collateral vessels in relation to the optimal needle tip position in cervical nerve root injections.

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This review aims to consolidate the published demographics, clinical and radiological features of calcific tendonitis affecting the linea aspera. Using the PRISMA protocol, 55 clinical cases were extracted from 19 shortlisted papers. In a patient presenting with thigh and/or hip pain, radiologic evaluation should commence with plain radiographs; subsequent cross-sectional imaging, if necessary.

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Background: The assessment of liver percentage fat fraction (%FF) using proton density fat fraction sequences is becoming increasingly accessible. Previous studies have tended to use multiple small ROIs that focus on Couinaud segments. In an effort to simplify day-to-day analysis, this study assesses the impact of using larger, elliptical ROIs focused on a single hepatic lobe.

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Article Synopsis
  • Primary care physicians in the region were given open access to knee MRI scans starting in 2008, prompting an evaluation of changes in referral practices and resource utilization.
  • A retrospective study analyzed knee MRI referrals from 2008 to 2015, revealing a significant increase in referrals, particularly from GPs, and a decrease in the average age of patients referred.
  • Despite the increase in referrals, the rate of conversion to arthroscopy declined, indicating no substantial change in inappropriate referrals, especially amongst elderly patients.
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Objectives: To assess whether initial or 12-18-month change in magnetic resonance imaging (MRI) subchondral bone texture is predictive of radiographic knee osteoarthritis (OA) progression over 36 months.

Methods: This was a nested case-control study including 122 knees/122 participants in the Osteoarthritis Initiative (OAI) Bone Ancillary Study, who underwent MRI optimised for subchondral bone assessment at either the 30- or 36-month and 48-month OAI visits. Case knees (n = 61) had radiographic OA progression between the 36- and 72-month OAI visits, defined as ≥ 0.

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Background The diagnostic accuracy of diffusion-weighted imaging (DWI) to detect prostate cancer is well-established. DWI provides visual as well as quantitative means of detecting tumor, the apparent diffusion coefficient (ADC). Recently higher b-values have been used to improve DWI's diagnostic performance.

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Purpose: To measure the test-retest reliability of rapid (<15 min) whole body and visceral fat volume quantification in normal and obese subjects on a widebore 3T MR system and compare it with conventional manual segmentation.

Materials And Methods: Thirty participants (body mass index [BMI] 20.1-48.

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Objective: To determine whether differences in the osteochondral junction (OCJ) in two different age groups could be detected with ultrashort time-to-echo (UTE) MRI in vivo.

Methods: 10 healthy controls aged 20-30 years (Group 1) and 10 patients aged 40-50 years with knee pain but no evidence of osteoarthritis (OA) (Group 2) underwent 3-T MRI of the knee using a two-dimensional UTE sequence. Evaluation of the presence/absence of a high-signal-intensity (SI) line at the medial tibial/lateral tibial (MT/LT) OCJ was performed.

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Article Synopsis
  • - The study aimed to assess whether MRI texture analysis can effectively quantify changes in the architecture of subchondral bone in patients with knee osteoarthritis (OA).
  • - Three groups of participants (asymptomatic young adults, symptomatic middle-aged patients, and elderly patients needing knee replacement) underwent advanced MRI scans, leading to notable differences in bone texture parameters between groups.
  • - Results indicated that MRI texture analysis is a promising and reliable method for detecting alterations in subchondral bone related to OA, which could enhance understanding of the disease and treatment responses.
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Background: The aim of this study was to compare two different methods of quantitative assessment of tibial subchondral bone in osteoarthritis (OA): statistical texture analysis (sTA) and trabecular microarchitecture analysis (tMA).

Methods: Asymptomatic controls aged 20-30 (n = 10), patients aged 40-50 with chronic knee pain but without established OA (n = 10) and patients aged 55-85 with advanced OA scheduled for knee replacement (n = 10) underwent knee MR imaging at 3 Tesla with a three-dimensional gradient echo sequence to allow sTA and tMA. tMA and sTA features were calculated using region of interest creation in the medial (MT) and lateral (LT) tibial subchondral bone.

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Article Synopsis
  • Artifact from metallic orthopedic prostheses is caused by inconsistencies in the magnetic field, leading to issues like signal voids and geometric distortion in imaging.
  • Reducing these artifacts can improve assessments of joint replacements and adjacent tissues, and advancements include using specific implant materials and enhancing MRI settings.
  • Newer techniques, such as MAVRIC and SEMAC, help minimize artifacts by capturing detailed 3D data and allowing for improved reconstruction of images with reduced distortion.
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Article Synopsis
  • The study aims to use dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to analyze quantitative pharmacokinetic parameters in healing bone, showing potential for assessing bone and marrow health.
  • Eight patients with extra-articular distal radial fractures were examined six weeks post-injury using DCE-MRI, measuring parameters like the transfer constant (K(trans)) and initial area under the curve (IAUC).
  • Results indicated variability in perfusion measures between patients and across slices, but showed "excellent" reliability, suggesting DCE-MRI can effectively evaluate healing fractures despite individual differences.
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Article Synopsis
  • The study aimed to identify differences in subchondral sclerosis at the tibial plateau using MRI across two age groups: 25-30 years old (Group A) and 45-50 years old (Group B).
  • Researchers measured cartilage thickness and created regions of interest in the tibial plateau using MRI images from 32 knees in each age group, analyzing the heterogeneity of signals in the bone.
  • Results showed a significant difference in medial subchondral bone sclerosis between the two groups, suggesting it may be an early indicator of osteoarthritis changes detectable by MRI, despite no typical signs of OA being present.
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The anterior cruciate ligament (ACL) has traditionally been described as having two bundles--one anteromedial and one posterolateral. This has been challenged by studies proposing the existence of a third, intermediate, bundle with distinct functional significance, an arrangement that has been described in a number of domesticated animal species. No radiological evidence for the triple bundle ACL has previously been described.

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Purpose: To measure the test-retest reproducibility of an automated system for quantifying whole body and compartmental muscle volumes using wide bore 3 T MRI.

Materials And Methods: Thirty volunteers stratified by body mass index underwent whole body 3 T MRI, two-point Dixon sequences, on two separate occasions. Water-fat separation was performed, with automated segmentation of whole body, torso, upper and lower leg volumes, and manually segmented lower leg muscle volumes.

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Background: The primary purpose of this study is to examine whether use of source data is effective in increasing the number of arterial segments that can be interpreted from maximum intensity projections of lower limb MR angiograms. Correlation between sites of arterial disease and venous contamination was also measured. Interpretation of source data is performed routinely by radiologists, but the value of this has not been well studied with randomized studies.

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Background: Adverse reaction to metal debris is a relatively recently described and often a silent complication of metal-on-metal (MOM) total hip replacements (THR). The Norfolk & Norwich University Hospital has been performing metal artefact reduction (MARS) MRI for 8 years in a variety of different types of MOM THR.

Questions/purposes: The aims of this review are to describe the experience of using MARS MRI in Norwich and to compare our experience with that published by other groups.

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