Characterization of pancreatic tumor motion using cine MRI: surrogates for tumor position should be used with caution.

Purpose: Our current understanding of intrafraction pancreatic tumor motion due to respiration is limited. In this study, we characterized pancreatic tumor motion and evaluated the application of several radiotherapy motion management strategies.

Methods And Materials: Seventeen patients with unresectable pancreatic cancer were enrolled in a prospective internal review board-approved study and imaged during shallow free-breathing using cine MRI on a 3T scanner.

Apparent wall thickening of cystic renal lesions on MRI.

Purpose: To show that cystic renal lesions that would otherwise meet criteria for simple cysts can demonstrate perceptible walls or increased wall thickness on MRI, sometimes causing these lesions to be "upgraded." It was hypothesized that thickening of cyst walls on MRI can be artifactual, due to data truncation, applied filtering, and low signal-to-noise ratio (SNR).

Materials And Methods: k-Space data for a 4-cm cyst were created in a 40-cm field of view (FOV) (512 x 512 matrix).

MR Imaging of hepatocellular carcinoma in the cirrhotic liver: challenges and controversies.

The incidence of hepatocellular carcinoma (HCC) is expected to increase in the next 2 decades, largely due to hepatitis C infection and secondary cirrhosis. HCC is being detected at an earlier stage owing to the implementation of screening programs. Biopsy is no longer required prior to treatment, and diagnosis of HCC is heavily dependent on imaging characteristics.

Sonography of uterine abnormalities in postpartum and postabortion patients: a potential pitfall of interpretation.

Objective: The interpretation of postpartum and postabortion uterine abnormalities on sonography can be challenging. The purpose of this study was to identify misleading imaging features that lead to inclusion of a uterine arteriovenous malformation (AVM) in the differential diagnosis of a uterine abnormality because consideration of this diagnosis can potentially alter patient treatment.

Methods: The sonographic examinations of 29 pathologically proven cases of uterine abnormalities in postpartum and postabortion patients were retrospectively reviewed.

Contrast-enhanced CT accurately detects hemorrhage in torso trauma: direct comparison with angiography.

Objective: To assess the ability of contrast enhanced computed tomography (CECT) to detect active hemorrhage and other vascular injuries in chest, abdominal, and pelvic trauma patients, using angiographic findings and need for intervention as paired gold standards.

Methods: We obtained approval from the Institutional review board for a retrospective search of the radiology information system: seeking trauma patients undergoing angiography within 24 hours of CECT for chest, abdominal, or pelvic injuries. CECT protocol was standard trauma CT, not specialized for CT angiography.

Frequency, management, and outcome of extravasation of nonionic iodinated contrast medium in 69,657 intravenous injections.

Purpose: To determine retrospectively the frequency, management, and outcomes of extravasations of intravenously injected nonionic iodinated contrast medium.

Materials And Methods: Institutional review board approval was obtained, and the requirement for informed consent was waived. The study was HIPAA compliant.

Full-dose gemcitabine and concurrent radiotherapy for unresectable pancreatic cancer.

Purpose: Full-dose gemcitabine and concurrent radiotherapy is a promising treatment approach in unresectable pancreatic cancer. This study was conducted to assess the pattern of failure and toxicity associated with the use of conformal treatment volumes, omitting prophylactic lymph node irradiation.

Methods And Materials: Seventy-four patients with locally advanced pancreatic cancer were treated between 1997 and 2005 with full-dose (1000 mg/m(2), Days 1, 8, and 15) gemcitabine and concurrent radiotherapy (36 Gy [median] in 15 daily fractions).

3D excretory MR urography: improved image quality with intravenous saline and diuretic administration.

Purpose: To assess the effect of diuretic administration on the image quality of excretory magnetic resonance urography (MRU) obtained following intravenous hydration, and to determine whether intravenous hydration alone is sufficient to produce diagnostic quality studies of nondilated upper tracts.

Materials And Methods: A total of 22 patients with nondilated upper tracts were evaluated with contrast-enhanced MRU. All patients received 250 mL of saline intravenously immediately prior to the examination.

MRI of sonographically indeterminate adnexal masses.

Objective: The purpose of this study was to assess the ability of MRI to characterize sonographically indeterminate adnexal masses and to define the sonographic features contributing to indeterminate diagnoses.

Materials And Methods: Two blinded radiologists retrospectively reviewed the MRI examinations of 87 patients with 95 sonographically indeterminate adnexal masses. Reviewers determined the origin of a mass, its tissue content (cystic, solid, complex cystic, or cystic and solid), tissue characteristics (fat, blood, fibrous, or leiomyomatous), and benignity versus malignancy.

Hepatic fat fraction: MR imaging for quantitative measurement and display--early experience.

Unlabelled: The institutional review board approved this HIPAA-compliant study. After all five patients with nonalcoholic fatty liver disease signed a consent, they underwent magnetic resonance (MR) imaging for hepatic fat quantification. The purpose of this study was to develop a fast and accurate method to acquire and display quantitative maps of the percentage of hepatic fat.

Magnetic resonance imaging of prostate cancer.

Management of carcinoma of the prostate has traditionally been guided by digital rectal examination, and by laboratory data such as serum prostate-specific antigen (PSA) level and histopathologic tumor grade. The introduction of the endorectal coil has improved the ability of magnetic resonance imaging (MRI) to contribute to staging and treatment planning of prostate cancer, especially in cases of confined or locally invasive disease. Exciting research in the fields of magnetic resonance spectroscopy (MRS) and MR-guided intervention of the prostate may soon expand the role of MRI in the diagnosis and treatment of prostate cancer.

MR imaging of the gallbladder.

T2-weighted imaging and MRCP, which have high sensitivity to edema and fluid, are paramount in the evaluation of certain gallbladder diseases, such as cholelithiasis, cholecystitis, adenomyomatosis, and cystic duct abnormalities. Dynamic gadolinium-enhanced MR imaging has the potential to differentiate among the many nonspecific-appearing lesions involving the gallbladder. MR imaging may not yet replace ultrasound as the workhorse of acute gallbladder imaging.