Proof-of-concept study linking ex vivo sensitivity testing to neoadjuvant anthracycline-based chemotherapy response in breast cancer patients.

We developed a functional ex vivo anthracycline-based sensitivity test. Surgical resection material of primary breast cancer (BC) was used to determine criteria for the ex vivo sensitivity assay based on morphology, proliferation and apoptosis. Subsequently, a proof-of-concept study was performed correlating results of this assay on primary BC biopsies with in vivo response after treatment with anthracycline-containing neoadjuvant chemotherapy (NAC).

Gamma probe and ultrasound-guided fine needle aspiration cytology of the sentinel node (GULF) trial.

Purpose: Sentinel lymph node biopsy (SLNB) was introduced as a minimally invasive technique for nodal staging. Since associated morbidity is not negligible, it is highly relevant to pursue a more minimally invasive alternative. The purpose of this study was to prospectively evaluate the sensitivity of fine needle aspiration cytology (FNAC) with combined gamma probe and ultrasound (US) guidance in comparison with the gold standard histology of the sentinel node (SN) after SLNB for detecting metastasis.

Gamma probe and ultrasound guided fine needle aspiration cytology of the sentinel node (GULF) trial - overview of the literature, pilot and study protocol.

Background: Sentinel node (SN) biopsy (SNB) detects clinically occult metastases of breast cancer and melanoma in 20-30%. Wound infections, seroma and lymph edema occur in up to 10%. Targeted ultrasound (US) of the SN, (with fine needle aspiration cytology (FNAC) if appropriate) has been investigated as a minimally invasive alternative, but reported sensitivity rates are too low to replace SNB.

Preoperative breast MRI can reduce the rate of tumor-positive resection margins and reoperations in patients undergoing breast-conserving surgery.

Objective: In breast cancer patients eligible for breast-conserving surgery, we evaluated whether the information provided by preoperative MRI of the breast would result in fewer tumor-positive resection margins and fewer reoperations.

Subjects And Methods: The study group consisted of 123 consecutive patients diagnosed with either breast cancer or ductal carcinoma in situ eligible for breast-conserving surgery between April 2007 and July 2010. For these patients, a first plan for breast-conserving surgery was made on the basis of clinical examination and conventional imaging.

Suspected carotid artery stenosis: cost-effectiveness of CT angiography in work-up of patients with recent TIA or minor ischemic stroke.

Purpose: To assess the effectiveness and cost-effectiveness of state-of-the-art noninvasive diagnostic imaging strategies in patients with a transient ischemic attack (TIA) or minor stroke who are suspected of having carotid artery stenosis (CAS).

Materials And Methods: All prospectively evaluated patients provided informed consent, and the local ethics committee approved this study. Diagnostic performance, treatment, long-term events, quality of life, and costs resulting from strategies employing duplex ultrasonography (US), computed tomographic (CT) angiography, contrast material-enhanced magnetic resonance (MR) angiography, and combinations of these modalities were modeled in a decision tree and Markov model.

Assessment of atherosclerotic carotid plaque volume with multidetector computed tomography angiography.

Purpose: The amount of atherosclerotic plaque and its components (calcifications, fibrous tissue, and lipid core) could be better predictors of acute events than the now currently used degree of stenosis. Therefore, we evaluated a dedicated software tool for volume measurements of atherosclerotic carotid plaque and its components in multidetector computed tomography angiography (MDCTA) images.

Materials And Methods: Data acquisition was approved by the Institutional Review Board and all patients gave written informed consent.

Is a fetal origin of the posterior cerebral artery a risk factor for TIA or ischemic stroke? A study with 16-multidetector-row CT angiography.

Background And Purpose: Fetal origin of the posterior cerebral artery (PCA) is not uncommon. Whether patients with this anomaly have a higher risk of ischemic stroke in the territory of the PCA is not known. The clinical benefit of screening for a fetal origin in patients with TIA or stroke in the territory of the PCA and an ipsilateral atherosclerotic carotid stenosis is not clear.

MDCT detection of fibromuscular dysplasia of the internal carotid artery.

Objective: The purpose of this article is to describe two cases in which fibromuscular dysplasia of the internal carotid artery was diagnosed with CT angiography.

Conclusions: CT angiography can depict the characteristic findings of fibromuscular dysplasia. If patients with cerebrovascular symptoms undergo screening with CT angiography of the supraaortic vessels, more cases of fibromuscular dysplasia will be recognized as a cause of neurologic symptoms.

Evaluation of an improved technique for lumen path definition and lumen segmentation of atherosclerotic vessels in CT angiography.

Vessel image analysis is crucial when considering therapeutical options for (cardio-) vascular diseases. Our method, VAMPIRE (Vascular Analysis using Multiscale Paths Inferred from Ridges and Edges), involves two parts: a user defines a start- and endpoint upon which a lumen path is automatically defined, and which is used for initialization; the automatic segmentation of the vessel lumen on computed tomographic angiography (CTA) images. Both parts are based on the detection of vessel-like structures by analyzing intensity, edge, and ridge information.

Optimization of CT angiography of the carotid artery with a 16-MDCT scanner: craniocaudal scan direction reduces contrast material-related perivenous artifacts.

Objective: The objective of our study was to compare the effect of a caudocranial scan direction versus a craniocaudal scan direction on arterial enhancement and perivenous artifacts in 16-MDCT angiography of the supraaortic arteries.

Subjects And Methods: Eighty consecutive patients (51 men; mean age, 62 years; age range, 28-89 years) underwent scanning in the caudocranial direction (group 1; n = 40) or the craniocaudal direction (group 2; n = 40). All patients received 80 mL of contrast material followed by a 40-mL saline chaser bolus, both administered IV at 4 mL/sec.

High iodine concentration contrast material for noninvasive multislice computed tomography coronary angiography: iopromide 370 versus iomeprol 400.

Objective: The objective of this study was to compare intracoronary attenuation on 16-row multislice computed tomography (16-MSCT) coronary angiography using 2 contrast materials (CM) with high iodine concentration.

Material And Methods: Forty consecutive patients (29 male, 11 female; mean age, 61+/-11 years) with suspected coronary artery disease were randomized to 2 groups to receive 100 mL of either iopromide 370 (group 1: Ultravist 370, 370 mg iodine/mL; Schering AG, Berlin, Germany) or iomeprol 400 (group 2: Iomeron 400, 400 mg iodine/mL; Bracco Imaging SpA, Milan, Italy). Both CM were administered at a rate of 4 mL/s.

Evaluation of an improved technique for automated center lumen line definition in cardiovascular image data.

The aim of the study was to evaluate a new method for automated definition of a center lumen line in vessels in cardiovascular image data. This method, called VAMPIRE, is based on improved detection of vessel-like structures. A multiobserver evaluation study was conducted involving 40 tracings in clinical CTA data of carotid arteries to compare VAMPIRE with an established technique.

Sixteen-detector row CT angiography of carotid arteries: comparison of different volumes of contrast material with and without a bolus chaser.

Purpose: To prospectively compare different volumes of intravenously administered contrast material with and without a bolus chaser at 16-detector row computed tomographic (CT) angiography of the carotid arteries.

Materials And Methods: Institutional Review Board approval and informed consent were obtained. Seventy-five consecutive patients (44 men, 31 women; mean age, 63 years; range, 22-85 years) were allocated to one of three protocols: group 1, 80 mL of contrast material; group 2, 80 mL of contrast material followed by 40 mL of saline; and group 3, 60 mL of contrast material followed by 40 mL of saline.