T1 mapping for the diagnosis of early chronic pancreatitis: correlation with Cambridge classification system

2021 ◽  
pp. 20200685
Author(s):  
Monica Cheng ◽  
Mark A Gromski ◽  
Evan L Fogel ◽  
John M DeWitt ◽  
Aashish A Patel ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
T1 Mapping ◽  
Early Stage ◽  
Relaxation Times ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Practical Method ◽  
T1 Relaxation ◽  
Imaging Protocols ◽  
Significant Difference ◽  
The Mean

Objective: This study aims to determine if T1 relaxation time of the pancreas can detect parenchymal changes in early chronic pancreatitis (CP). Methods: This study retrospectively analyzed 42 patients grouped as no CP (Cambridge 0; n = 21), equivocal (Cambridge 1; n = 12) or mild CP (Cambridge 2; n = 9) based on magnetic resonance cholangiopancreatography findings using the Cambridge classification as the reference standard. Unenhanced T1 maps were acquired using a three-dimensional dual flip-angle gradient-echo technique on the same 1.5 T scanner with the same imaging parameters. Results: There was no significant difference between the T1 relaxation times of Cambridge 0 and 1 group (p = 0.58). There was a significant difference (p = 0.0003) in the mean T1 relaxation times of the pancreas between the combined Cambridge 0 and 1 (mean = 639 msec, 95% CI: 617, 660) and Cambridge 2 groups (mean = 726 msec, 95% CI: 692, 759). There was significant difference (p = 0.0009) in the mean T1 relaxation times of the pancreas between the Cambridge 0 (mean = 636 msec, 95% CI: 606, 666) and Cambridge 2 groups (mean = 726 msec, 95% CI: 692,759) as well as between Cambridge 1 (mean = 643 msec, 95% CI: 608, 679) and Cambridge 2 groups (mean = 726 msec, 95% CI: 692,759) (p = 0.0017). Bland–Altman analysis showed measurements of one reader to be marginally higher than the other by 15.7 msec (2.4%, p = 0.04). Conclusion: T1 mapping is a practical method capable of quantitatively reflecting morphologic changes even in the early stages of chronic pancreatitis, and demonstrates promise for future implementation in routine clinical imaging protocols. Advances in knowledge: T1 mapping can distinguish subtle parenchymal changes seen in early stage CP, and demonstrates promise for implementation in routine imaging protocols for the diagnosis of CP.

scholarly journals Diagnostic value of research methods in diagnostics of chronic pancreatitis

2021 ◽  
Vol 102 (4) ◽  
pp. 528-536
Author(s):  
G R Aliyeva
Keyword(s):  
Chronic Pancreatitis ◽  
Early Stage ◽  
Imaging Modality ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Clinical History ◽  
Diagnostic Value ◽  
Diagnostic Tools ◽  
Invasive Approach ◽  
Pancreas Function ◽  
Function Testing

Chronic pancreatitis remains an unsolved problem for clinicians. One of the biggest dilemmas is to establish a clear diagnosis. Diagnosis can be particularly elusive in patients with early chronic pancreatitis. Many studies have been undertaken to improve diagnostics in chronic pancreatitis, but this has been significantly limited by the lack of a gold standard. The evaluation of patients with suspected chronic pancreatitis should follow a progressively non-invasive to more invasive approach. Computed tomography is the best primary imaging modality to obtain as it has good sensitivity for severe chronic pancreatitis and may exclude the need for other diagnostic tests. When ambiguous results are obtained, a magnetic resonance cholangiopancreatography may require for a more detailed evaluation of both the pancreatic parenchyma and ducts. If the diagnosis remains in doubt, endoscopic ultrasound with or without pancreas function testing becomes the preferred method. Endoscopic retrograde cholangiopancreatography remains a last line diagnostic test and generally should be used only for diagnostic purposes. Future researches in the field of diagnosis of early-stage chronic pancreatitis should purpose optimizing current diagnostic tools. A definitive diagnosis of chronic pancreatitis may not be made simply by clinical history, imaging or function testing alone, but rather by the data gathered by a combination of these diagnostic tools.

scholarly journals Quantitative T1 mapping of the normal brain from early infancy to adulthood

2020 ◽  
Author(s):  
Daniel Gräfe ◽  
Jens Frahm ◽  
Andreas Merkenschlager ◽  
Dirk Voit ◽  
Franz Wolfgang Hirsch
Keyword(s):  
White Matter ◽  
Spatial Resolution ◽  
Gray Matter ◽  
T1 Mapping ◽  
Relaxation Times ◽  
Early Infancy ◽  
Normal Brain ◽  
Regression Equations ◽  
T1 Relaxation ◽  
Pediatric Brain

Abstract Background Quantitative mapping of MRI relaxation times is expected to uncover pathological processes in the brain more subtly than standard MRI techniques with weighted contrasts. So far, however, most mapping techniques suffer from a long measuring time, low spatial resolution or even sensitivity to magnetic field inhomogeneity. Objective To obtain T1 relaxation times of the normal brain from early infancy to adulthood using a novel technique for fast and accurate T1 mapping at high spatial resolution. Materials and methods We performed whole-brain T1 mapping within less than 3 min in 100 patients between 2 months and 18 years of age with normal brain at a field strength of 3 T. We analyzed T1 relaxation times in several gray-matter nuclei and white matter. Subsequently, we derived regression equations for mean value and confidence interval. Results T1 relaxation times of the pediatric brain rapidly decrease in all regions within the first 3 years of age, followed by a significantly weaker decrease until adulthood. These characteristics are more pronounced in white matter than in deep gray matter. Conclusion Regardless of age, quantitative T1 mapping of the pediatric brain is feasible in clinical practice. Normal age-dependent values should contribute to improved discrimination of subtle intracerebral alterations.

scholarly journals Validation and feasibility of liver T1 mapping using free breathing MOLLI sequence in children and young adults

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yeon Jin Cho ◽  
Woo Sun Kim ◽  
Young Hun Choi ◽  
Seul Bi Lee ◽  
SeungHyun Lee ◽  
...  
Keyword(s):  
Young Adults ◽  
Relaxation Times ◽  
Free Breathing ◽  
Phantom Study ◽  
Inversion Recovery ◽  
Breath Hold ◽  
T1 Relaxation ◽  
Molli Sequence ◽  
Children And Young Adults ◽  
The Mean

Abstract We investigated the feasibility of free-breathing modified Look-Locker inversion recovery (MOLLI) sequence for measuring hepatic T1 values in children and young adults. To investigate the accuracy and the reproducibility of the T1 maps, a phantom study was performed with 12 different gadoterate meglumine concentrations and the T1 relaxation times of phantoms measured with the MOLLI sequence were compared against those measured with three different sequences: spin-echo inversion recovery, variable flip angle (VFA), and VFA with B1 correction. To evaluate the feasibility of free-breathing MOLLI sequence, hepatic T1 relaxation times obtained by free-breathing and breath-hold technique in twenty patients were compared. The phantom study revealed the excellent accuracy and reproducibility of MOLLI. In twenty patients, the mean value of hepatic T1 values obtained by free-breathing (606.7 ± 64.5 ms) and breath-hold (609.8 ± 64.0 ms) techniques showed no significant difference (p > 0.05). The Bland–Altman plot between the free-breathing and breath-hold revealed that the mean difference of T1 values was − 3.0 ms (− 0.5%). Therefore, T1 relaxation times obtained by MOLLI were comparable to the values obtained using the standard inversion recovery method. The hepatic T1 relaxation times measured by MOLLI technique with free-breathing were comparable to those obtained with breath-hold in children and young adults.

scholarly journals T1 Relaxation Times in the Cortex and Thalamus Are Associated With Working Memory and Information Processing Speed in Patients With Multiple Sclerosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Christian Thaler ◽  
Isabelle Hartramph ◽  
Jan-Patrick Stellmann ◽  
Christoph Heesen ◽  
Maxim Bester ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Working Memory ◽  
Cognitive Impairment ◽  
Information Processing ◽  
Processing Speed ◽  
T1 Mapping ◽  
Relaxation Times ◽  
Healthy Controls ◽  
Information Processing Speed ◽  
T1 Relaxation

Background: Cortical and thalamic pathologies have been associated with cognitive impairment in patients with multiple sclerosis (MS).Objective: We aimed to quantify cortical and thalamic damage in patients with MS using a high-resolution T1 mapping technique and to evaluate the association of these changes with clinical and cognitive impairment.Methods: The study group consisted of 49 patients with mainly relapsing-remitting MS and 17 age-matched healthy controls who received 3T MRIs including a T1 mapping sequence (MP2RAGE). Mean T1 relaxation times (T1-RT) in the cortex and thalami were compared between patients with MS and healthy controls. Additionally, correlation analysis was performed to assess the relationship between MRI parameters and clinical and cognitive disability.Results: Patients with MS had significantly decreased normalized brain, gray matter, and white matter volumes, as well as increased T1-RT in the normal-appearing white matter, compared to healthy controls (p < 0.001). Partial correlation analysis with age, sex, and disease duration as covariates revealed correlations for T1-RT in the cortex (r = −0.33, p < 0.05), and thalami (right thalamus: r = −0.37, left thalamus: r = −0.50, both p < 0.05) with working memory and information processing speed, as measured by the Symbol-Digit Modalities Test.Conclusion: T1-RT in the cortex and thalamus correlate with information processing speed in patients with MS.

Abstract 18706: Multi-Sequence Non-Contrast MRI Characterisation of Experimental Venous Thrombi Predicts Susceptibility to Lysis and is Feasible in Man

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Prakash Saha ◽  
Alkystis Phinikaridou ◽  
Marcelo E Andia ◽  
Ashish S Patel ◽  
Steven P Grover ◽  
...  
Keyword(s):  
T1 Mapping ◽  
Relaxation Times ◽  
Magnetisation Transfer ◽  
Roc Curve Analysis ◽  
Venous Thrombus ◽  
Vein Thrombosis ◽  
Diffusion Weighted Images ◽  
T1 Relaxation ◽  
Apparent Diffusion ◽  
Deep Vein

Introduction: We have previously demonstrated that non-contrast MRI using magnetisation transfer rate (MTR), apparent diffusion coefficient (ADC) and T1 mapping can characterise different aspects of organisation in a resolving venous thrombus. We now investigate whether the combination of these non-contrast agent MRI sequences can be used to identify thrombi suitable for lysis in an experimental model, and whether multi-sequence thrombus imaging (MSTI) can be translated to man. Methods: Magnetisation transfer, diffusion weighted images and T1 relaxation times were measured at days 2, 4, 7, 10, 14, 21 and 28 after venous thrombus induction in 8-10wk old male BALB/C mice (n=8/gp). Tissue plasminogen activator (10mg/kg) was administered through tail vein injection immediately after imaging at each time point and mice scanned 24hrs later to evaluate the effect of lysis. This was considered successful if more than 50% of the vein recanalised. Murine imaging sequences were combined and optimised to image the pelvic veins in man using healthy volunteers in order to produce a clinically useable imaging card. MSTI sequences were validated using phantoms before application to patients with iliofemoral deep vein thrombosis (DVT) undergoing lysis. Results: ROC curve analysis shows that the combination of MTR smaller than 2,900(%/cm3), ADC larger than 0.93(x10-3 mm2/s) and T1 shorter than 784ms has a sensitivity of 88% and specificity of 97% to identify experimental thrombi amenable to lysis. MSTI is feasible in man, with optimisation leading to successful characterisation of iliofemoral DVT in under 25mins (Figure 1). Conclusions: Non-contrast MR imaging, using a combination of MTR, ADC and T1 mapping, accurately identifies experimental venous thrombi susceptible to lysis. These MSTI sequences can also be readily translated to man where may find utility in characterising the age and structure of thrombus, and to stratify patients undergoing thrombolysis.

T1 relaxation times and MR elastography-derived stiffness: new potential imaging biomarkers for the assessment of chronic pancreatitis

2021 ◽  
Author(s):  
Emily Steinkohl ◽  
Søren Schou Olesen ◽  
Tine Maria Hansen ◽  
Asbjørn Mohr Drewes ◽  
Jens Brøndum Frøkjær
Keyword(s):  
Chronic Pancreatitis ◽  
Relaxation Times ◽  
Imaging Biomarkers ◽  
Mr Elastography ◽  
T1 Relaxation

scholarly journals Comparison of shared decision making in patients undergoing hemodialysis and peritoneal dialysis for choosing a dialysis modality

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sepide Ghodsian ◽  
Mansour Ghafourifard ◽  
Akram Ghahramanian
Keyword(s):  
Decision Making ◽  
Peritoneal Dialysis ◽  
Shared Decision Making ◽  
Early Stage ◽  
T Test ◽  
Shared Decision ◽  
Dialysis Modality ◽  
Care Providers ◽  
Significant Difference ◽  
The Mean

Abstract Background Shared decision making (SDM) is recognized as the gold standard for patient-centered care. This study aimed to assess and compare the SDM among patients undergoing hemodialysis and peritoneal dialysis for choosing a dialysis modality. Methods This is a cross-sectional study that was performed on 300 dialysis patients (218 HD and 82 PD) referred to two Dialysis Centers. Data were collected using demographic information and a 9-item Shared Decision Making Questionnaire (SDM-Q-9). The data were analyzed using ANOVA and independent t-test by SPSS software. Results The mean SDM-Q-9 score in all samples (PD and HD) was 21.94 ± 15.08 (in a possible range of 0 to 45). Results of the independent t-test showed that the mean SDM-Q-9 score in PD patients (33.11 ± 10.08) was higher than HD patients (17.14 ± 74.24) (p < 0.001). The results showed a statistically significant difference in mean SDM-Q-9 score based on patients’ age, educational level, and income (p < 0.05). Conclusion Implementing shared decision making and providing information on RRT should be started in the early stage of CKD. The health care providers should involve patients with CKD and their families in dialysis-related decisions and it should be started in the early stage of CKD.

The evolution of breast cancer screening in the Medicare population: Clinical and economic implications.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1595-1595
Author(s):  
Brigid K. Killelea ◽  
Jessica B. Long ◽  
Xiaomei Ma ◽  
Rong Wang ◽  
Anees B. Chagpar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Digital Mammography ◽  
Early Stage ◽  
Early Period ◽  
Stage At Diagnosis ◽  
Economic Implications ◽  
Medicare Program ◽  
Significant Difference ◽  
The Mean

1595 Background: Breast screening has evolved as newer approaches to mammography, ultrasound, and MRI have diffused into clinical practice. The use of these technologies and their impact on screening-related costs and outcomes remain undefined, particularly among older women. Methods: Using the Surveillance Epidemiology and End Results – Medicare linked database, we identified women aged 66 and older without a diagnosis of breast cancer. We constructed two cohorts (2001 vs. 2006) and followed each for two years. We assessed changes in imaging technology, screening-related costs (defined as costs for screening and subsequent imaging and testing, adjusted to 2009 USD), and stage at diagnosis between the two cohorts. Results: There were 136,845 women in the 2001-2002 (earlier) cohort and 137,733 in the 2006-2007 (later) cohort. The mean age was 76.9 and 77.2 respectively, (p<.001). The proportion of women receiving any screening mammogram was 42.5% in the earlier cohort and 43.4% in the later cohort, (p<.001). The use of digital mammography for screening increased from 2.2% to 15.0%, (p<.001). The use of any computer aided detection (CAD) increased from 3.2% to 29.3% (p<.001). MRI use increased from 0.03% to 0.2%, and ultrasound use from 4.0% to 4.5% (p <.001 for both). Average screening-related cost increased 31%, from $101 to $132 (p<.001). There was no significant difference in early stage at diagnosis over time (58.1% of women were in situ/stage I in early period vs. 57.2% in later period, p=.65). Conclusions: The use of digital mammography and CAD increased substantially between 2001 and 2007, contributing to a 31% increase in screening-related costs for women in the Medicare program. The increased cost of screening and downstream testing must be evaluated in context of an absence of benefit in terms of stage at diagnosis.

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