Value of Relative Myocardial Perfusion at MRI for Fractional Flow Reserve-Defined Ischemia: A Pilot Study.

Correcting the perfusion in areas distal to coronary stenosis (risk) according to that of normal (remote) areas defines the relative myocardial perfusion index, which is similar to the fractional flow reserve (FFR) concept. The aim of this study was to assess the value of relative myocardial perfusion by MRI in predicting lesion-specific inducible ischemia as defined by FFR. Forty-six patients (33 men and 13 women; mean [± SD] age, 61 ± 9 years) who underwent adenosine perfusion MRI and FFR measurement distal to 49 coronary artery stenoses during coronary angiography were retrospectively evaluated.

Correlation of FFR-derived from CT and stress perfusion CMR with invasive FFR in intermediate-grade coronary artery stenosis.

Only one-third of intermediate-grade coronary artery stenosis (i.e. 40-70% diameter narrowing) causes myocardial ischemia, requiring most often additional invasive work-up with invasive fractional flow reserve (FFR).

Prolonged release oxycodone and naloxone treatment counteracts opioid-induced constipation in patients with severe pain compared to previous analgesic treatment.

Objective: Treatment with prolonged-release oxycodone/naloxone (PR OXN) has been shown to improve opioid induced constipation (OIC) in constipated patients. This publication reports on a real-life observational study investigating the efficacy of PR OXN with regard to bowel function in patients switching to PR OXN from WHO step 1, step 2 and step 3 opioids.

Methods: Patients with chronic pain experiencing insufficient pain relief and/or unacceptable side effects were switched to PR OXN and monitored in this observational study with respect to efficacy regarding bowel function and efficacy regarding pain relief in comparison with previous analgesic therapy.

Image quality in coronary CT angiography: challenges and technical solutions.

Multidetector CT angiography (CTA) has become a widely accepted examination for non-invasive evaluation of the heart and coronary arteries. Despite its ongoing success and worldwide clinical implementation, it remains an often-challenging procedure in which image quality, and hence diagnostic value, is determined by both technical and patient-related factors. Thorough knowledge of these factors is important to obtain high-quality examinations.

Coronary Computed Tomography Angiography: Patient-related factors determining image quality using a second-generation 320-slice CT scanner.

Purpose: To investigate the diagnostic confidence of Coronary Computed Tomography Angiography (CCTA) and the effect of patient-related factors on CCTA image quality using a second-generation 320-slice scanner.

Methods And Results: 200 consecutive patients (mean age 60±12years; 109 men) prospectively underwent CCTA. The mean body mass index (BMI) was 27.

Diagnostic performance of quantitative coronary computed tomography angiography and quantitative coronary angiography to predict hemodynamic significance of intermediate-grade stenoses.

Fractional flow reserve (FFR) during invasive coronary angiography has become an established tool for guiding treatment. However, only one-third of intermediate-grade coronary artery stenosis (ICAS) are hemodynamically significant and require coronary revascularization. Additionally, the severity of stenosis visually established by coronary computed tomography angiography (CCTA) does not reliably correlate with the functional severity.

Influence of the cardiac cycle on time-intensity curves using multislice dynamic magnetic resonance perfusion.

Flow and pressure variations cause potential changes in magnetic resonance imaging (MRI) signal intensity across the cardiac cycle. Nevertheless, cardiac dynamic contrast-enhanced (perfusion) MRI is performed and analyzed regardless of the cardiac phase. We investigate whether the cardiac phase impacts myocardial and left ventricle (LV) cavity time intensity curves (TICs) at rest and during vasodilatation.

Free-breathing accelerated gadolinium-enhanced MR Angiography in the Diagnosis of Renovascular Disease.

Objective: The purpose of this study was to assess the feasibility and accuracy of accelerated free-breathing and breath-hold gadolinium-enhanced MR angiography of the main renal arteries compared with digital subtraction angiography.

Materials And Methods: Renal MR angiograms and catheter angiograms of 47 patients (19 men, 28 women; mean age, 68.1 +/- 15.

Virtual dissection CT colonography: evaluation of learning curves and reading times with and without computer-aided detection.

Purpose: To prospectively evaluate the learning curves and reading times of inexperienced readers who used the virtual dissection reading method for retrospective computed tomographic (CT) colonography data sets, with and without concurrent computer-aided detection (CAD).

Materials And Methods: An Institutional Review Board approved this study; informed consent was waived. Four radiologists without experience in CT colonography evaluated 100 optical colonoscopy-proved data sets of 100 patients (49 men, 51 women; mean age, 59 years +/- 13 [standard deviation]; range, 21-85 years) by using the virtual dissection reading method.

Progress and new standards of care in the management of HER-2 positive breast cancer.

The aim of this review article is to examine the available evidence regarding diagnosis and treatment of HER-2 positive breast cancer. This group of breast tumours (up to 30% of the total number of breast cancers) is known for having a more aggressive behaviour. The current recommendations for HER-2 positive tumour diagnosis are discussed since accurate identification of HER-2 amplification or overexpression is key for allowing a correct risk assessment and treatment.

Efficacy and safety of ibandronate in the treatment of opioid-resistant bone pain associated with metastatic bone disease: a pilot study.

Purpose: Bone metastases are associated with severe and sometimes intractable pain, compromising patient quality of life (QOL). This open-label pilot study investigated the effects of short-term intensive treatment with intravenous (i.v.

Treatment of tumor-induced hypercalcemia: a solved problem?

Less than 25 years ago, tumor-induced hypercalcemia was often a lethal complication of cancer. Nowadays, it can be successfully and easily treated in at least 90% of the cases by rehydration and potent antiosteoclastic bisphosphonates. The standard therapy consists of the administration of 90 mg of pamidronate (Aredia Dry Powder) or more recently, 4 mg of zoledronic acid (Zometa)], which is even more efficient, at least in patients without bone metastases.

Loss of left ventricular epicardial lead capture due to pneumothorax.

Pneumothorax is a rare complication of pacemaker lead insertion by subclavian way. We report a case of temporary ineffective biventricular pacing due to pneumothorax. This complication has to be ruled out before electing to reposition or to replace the lead.