Updated S3 Guidelines - Diagnosis and Treatment of Colorectal Carcinoma: Relevance for Radiological Diagnosis and Intervention.

The updated German S3 guidelines "Colorectal Carcinoma" were created as part of the oncology program of the Association of the Scientific Medical Societies (AWMF), German Cancer Society and the German Cancer Aid under the auspices of the German Society for Digestive and Metabolic Disorders (DGVS) and they replace the previous guidelines from 2013. The main changes in the updated guidelines include the latest recommendations regarding endoscopy and adjuvant/neoadjuvant therapies as well as a complete restructuring of the section regarding therapeutic approach in metastases and in the palliative situation. The present manuscript discusses the importance of the current recommendations for radiological diagnosis and treatment and is intended to enhance the quality of patient information and patient care by widespread distribution.

A thermometry software tool for monitoring laser-induced interstitial thermotherapy.

The purpose of this study was to develop a thermometry software tool for temperature monitoring during laser-induced interstitial thermotherapy (LITT). C++ programming language and several libraries including DICOM Toolkit, Grassroots DICOM library, Insight Segmentation and Registration Toolkit, Visualization Toolkit and Quasar Toolkit were used. The software's graphical user interface creates windows displaying the temperature map and the coagulation extent in the tissue, determined by the magnetic resonance imaging (MRI) thermometry with the echo planar imaging sequence and a numerical simulation based on the radiation and heat transfer in biological tissues, respectively.

The value of different F-FDG PET/CT baseline parameters in risk stratification of stage I surgical NSCLC patients.

Objective: Administration of postoperative chemotherapy to patients with completely resected stage I NSCLC is still a matter of debate. The aim of the present study was to evaluate the value of different baseline F-FDG PET parameters in identifying surgical stage I NSCLC patients who are at high risk of recurrence, and thus are indicated for further postoperative treatment.

Methods: This is a retrospective study, which included 49 patients (28 males, 21 females) with the median age of 69 years (range 28-84), who had pathologically proven stage I NSCLC.

Evaluation of Radiation Dose and Image Quality using High-Pitch 70-kV Chest CT in Immunosuppressed Patients.

Purpose:  The aim of the study was to evaluate high-pitch 70-kV CT examinations of the thorax in immunosuppressed patients regarding radiation dose and image quality in comparison with 120-kV acquisition.

Materials And Methods:  The image data from 40 patients (14 women and 26 men; mean age: 40.9 ± 15.

Dual-energy CT in patients with colorectal cancer: Improved assessment of hypoattenuating liver metastases using noise-optimized virtual monoenergetic imaging.

Purpose: To assess the value of the noise-optimized virtual monoenergetic imaging (VMI+) technique on quantitative and qualitative image parameters in patients with hypoattenuating liver metastases from colorectal cancer (CRC) at abdominal dual-energy CT (DECT).

Materials And Methods: Fifty-three consecutive patients (mean age, 70.3 ± 11.

Comparison of X-ray-Mammography and Planar UWB Microwave Imaging of the Breast: First Results from a Patient Study.

Hemispherical and cylindrical antenna arrays are widely used in radar-based and tomography-based microwave breast imaging systems. Based on the dielectric contrast between healthy and malignant tissue, a three-dimensional image could be formed to locate the tumor. However, conventional X-ray mammography as the golden standard in breast cancer screening produces two-dimensional breast images so that a comparison between the 3D microwave image and the 2D mammogram could be difficult.

Case 257: Leiomyosarcoma of the Inferior Vena Cava.

History A 65-year-old woman presented to her primary care physician with a history of progressive abdominal pain mainly in the upper quadrants, nausea, and edema in the bilateral symmetric lower extremities. Other symptoms and use of medication or related drugs were denied. Physical examination findings were normal.

Evaluation of a Computer-Aided Diagnosis System for Automated Bone Age Assessment in Comparison to the Greulich-Pyle Atlas Method: A Multireader Study.

Objective: The aim of this study was to investigate a novel version of a computer-aided diagnosis (CAD) system developed for automated bone age (BA) assessment in comparison to the Greulich and Pyle method, regarding its accuracy and the influence of carpal bones on BA assessment.

Methods: Total BA, BA of the left distal radius, and BA of carpal bones in 305 patients were determined independently by 3 blinded radiologists and assessed by the CAD system. Pearson product-moment correlation, Bland-Altman plot, root-mean-square deviation, and further agreement analyses were computed.

High-sensitive troponin is associated with subclinical imaging biosignature of inflammatory cardiovascular involvement in systemic lupus erythematosus.

Background: Cardiovascular (CV) involvement in patients with systemic lupus erythematosus (SLE) is presumably subclinical for the major part of its evolution. We evaluated the associations between high-sensitive troponin T (hs-TropT), a sensitive marker of myocardial injury, and CV involvement using cardiac magnetic resonance (CMR).

Methods And Results: This is a two-centre (London and Frankfurt) CMR imaging study at 3.

Indication of whole body computed tomography in pediatric polytrauma patients-Diagnostic potential of the Glasgow Coma Scale, the mechanism of injury and clinical examination.

Objective: To evaluate the diagnostic potential of the Glasgow Coma Scale (GCS), the mechanism of injury (MOI) and clinical examination (CE) for the indication of whole body computed tomography (WBCT) in pediatric polytrauma patients.

Materials & Methods: 100 pediatric polytrauma patients with WBCT were analysed in terms of age, gender, (MOI), GCS, detected injury, FAST, CE and Injury Severity Score (ISS). Correlations between all clinical variables and patient groups with (p+) and without (p-) injury were assessed.

Dual-energy CT-based iodine quantification to differentiate abdominal malignant lymphoma from lymph node metastasis.

Purpose: To investigate the value of dual-energy computed tomography (DECT)-derived iodine and fat quantification in differentiating malignant abdominal lymphoma from lymph node metastasis.

Materials And Methods: In this retrospective study, 59 patients (39 men; mean age, 62.7 years) with histopathologically-confirmed diagnosis of either malignant lymphoma or lymph node metastasis were included.

Iodine quantification to distinguish hepatic neuroendocrine tumor metastasis from hepatocellular carcinoma at dual-source dual-energy liver CT.

Purpose: To investigate the value of third-generation dual-source dual-energy computed tomography (DECT) iodine quantification to distinguish hepatic neuroendocrine tumor (NET) metastasis from hepatocellular carcinoma (HCC) in non-cirrhotic liver parenchyma.

Material And Methods: Forty-six patients (mean age, 64.9 ± 10.

Dual-energy CT of the heart current and future status.

Several applications utilizing dual-energy cardiac CT (DECT) have recently transitioned from the realm of research into clinical workflows. DECT acquisition techniques and subsequent post-processing can provide improved qualitative analysis, allow quantitative imaging, and have the potential to decrease requisite radiation and contrast material doses. Additionally, several experimental DECT techniques are pending further investigation and may improve the diagnostic accuracy of cardiac CT and/or provide evaluation of emerging imaging biomarkers in the future.

Transarterial Chemoembolization (TACE) Using Mitomycin with or without Irinotecan for Hepatocellular Carcinoma in European Patients.

Background: We evaluated survival data and local tumor control in 2 groups of patients with hepatocellular carcinoma (HCC) treated with different chemotherapeutic agents for transarterial chemoembolization (TACE).

Methods: 28 patients (median age 63 years) with HCC were repeatedly treated with chemoembolization at 4-week intervals. 20 patients had Barcelona Clinic Liver Cancer (BCLC) stage B, while 8 patients obtained chemoembolization for bridging purposes (BCLC stage A).

90-kVp low-tube-voltage CT pulmonary angiography in combination with advanced modeled iterative reconstruction algorithm: effects on radiation dose, image quality and diagnostic accuracy for the detection of pulmonary embolism.

Objective: To evaluate low-tube-voltage 90-kVp CT pulmonary angiography (CTPA) with advanced modeled iterative reconstruction algorithm (Admire) compared to 120-kVp equivalent dual-energy (DE) acquisition with regards to radiation exposure, image quality and diagnostic accuracy for pulmonary embolism (PE) assessment.

Methods: CTPA studies of 40 patients with suspected PE (56.7 ± 16.

Dynamic 4D-CT Angiography for Guiding Transarterial Chemoembolization: Impact on the Reduction of Contrast Material, Operator Radiation Exposure, Catheter Consumption, and Diagnostic Confidence.

Purpose:  This study was carried out to investigate the impact of abdominal dynamic four-dimensional CT angiography (4D-CTA) for guiding transarterial chemoembolization (TACE) on the amount of contrast material used, operator radiation exposure, catheter consumption, and diagnostic confidence.

Materials And Methods:  Written consent was waived for this IRB-approved retrospective study. 29 patients (20 men; mean age: 65.

Survival of patients with non-resectable, chemotherapy-resistant colorectal cancer liver metastases undergoing conventional lipiodol-based transarterial chemoembolization (cTACE) palliatively versus neoadjuvantly prior to percutaneous thermal ablation.

Purpose: To determine overall (OS) and progression-free survival (PFS) for cTACE alone and in combination with percutaneous thermal ablation in patients with non-resectable, chemotherapy-resistant colorectal cancer liver metastases (CRLM).

Material And Methods: The study included 452 patients undergoing 2654 repetitive cTACE treatments of CRLM. 233 patients were treated palliatively using only cTACE, whereas 219 patients were treated with cTACE in a neoadjuvant intend with subsequent thermal ablation (either microwave ablation or laser-induced thermotherapy).

Beam-hardening in 70-kV Coronary CT angiography: Artifact reduction using an advanced post-processing algorithm.

Purpose: To investigate the effect of an iterative beam-hardening correction algorithm (iBHC) on artifact reduction and image quality in coronary CT angiography (cCTA) with low tube voltage.

Material And Methods: Thirty-six patients (17 male, mean age, 57.3 ± 14.

Diagnostic yield of 90-kVp low-tube-voltage carotid and intracerebral CT-angiography: effects on radiation dose, image quality and diagnostic performance for the detection of carotid stenosis.

Objective: To investigate the impact of low-tube-voltage 90-kVp acquisition combined with advanced modeled iterative reconstruction algorithm (Admire) on radiation exposure, image quality, artifacts, and assessment of stenosis in carotid and intracranial CT angiography (CTA).

Methods: Dual-energy CTA studies of 43 patients performed on a third-generation 192-slice dual-source CT were retrospectively evaluated. Intraindividual comparison of 90-kVp and linearly blended 120-kVp equivalent image series (M_0.

Dual-Energy Computed Tomography-Based Display of Bone Marrow Edema in Incidental Vertebral Compression Fractures: Diagnostic Accuracy and Characterization in Oncological Patients Undergoing Routine Staging Computed Tomography.

Purpose: The aim of this study was to evaluate the diagnostic performance of virtual noncalcium (VNCa) dual-energy computed tomography (DECT) reconstructions enabling visualization of bone marrow edema for characterization of incidental thoracolumbar compression fractures in routine thoracoabdominal staging computed tomography (CT).

Materials And Methods: We retrospectively analyzed 51 oncological patients without suspected fracture or indicative complaints presenting at least 1 thoracolumbar compression fracture on routine thoracoabdominal staging DECT who had been examined between October 2015 and June 2017 using third-generation dual-source CT, had a previous CT within 3 months before, and also had undergone additional magnetic resonance imaging within 14 days, which served as the standard of reference. Three independent and blinded radiologists initially evaluated all vertebrae on conventional grayscale DECT series; after at least 8 weeks, observers reevaluated all cases using grayscale and color-coded VNCa DECT images.

Characterization of Severe Arterial Phase Respiratory Motion Artifact on Gadoxetate Disodium-Enhanced MRI - Assessment of Interrater Agreement and Reliability.

Purpose:  To assess the interrater agreement and reliability of experienced abdominal radiologists in the characterization and grading of arterial phase gadoxetate disodium-related respiratory motion artifact on liver MRI.

Materials And Methods:  This prospective multicenter study was initiated by the working group for abdominal imaging within the German Roentgen Society (DRG), and approved by the local IRB of each participating center. 11 board-certified radiologists independently reviewed 40 gadoxetate disodium-enhanced liver MRI datasets.

Selective targeting of tumor associated macrophages in different tumor models.

Tumor progression largely depends on the presence of alternatively polarized (M2) tumor-associated macrophages (TAMs), whereas the classical M1-polarized macrophages can promote anti-tumorigenic immune responses. Thus, selective inhibition of M2-TAMs is a desirable anti-cancer approach in highly resistant tumor entities such as hepatocellular carcinoma (HCC) or breast cancer. We here examined whether a peptide that selectively binds to and is internalized by in vitro-differentiated murine M2 macrophages as compared to M1 macrophages, termed M2pep, could be used to selectively target TAMs in HCC and breast carcinoma.

Transarterial chemoembolization (TACE) using mitomycin and lipiodol with or without degradable starch microspheres for hepatocellular carcinoma: comparative study.

Background: To evaluate survival data and local tumor control after transarterial chemoembolization in two groups with different embolization protocols for the treatment of HCC patients.

Methods: Ninty-nine patients (mean age: 63.6 years), 78 male (78.