Over the last fifteen years, our understanding of the pathophysiology of atrial fibrillation (AF) has paved the way for ablation to be utilized as an effective treatment option. With the aim of gaining more detailed anatomical representation, advances have been made using various imaging modalities, both before and during the ablation procedure, in planning and execution. Options have flourished from procedural fluoroscopy, electroanatomic mapping systems, preprocedural computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and combinations of these technologies. Exciting work is underway in an effort to allow the electrophysiologist to assess scar formation in real time. One advantage would be to lessen the learning curve for what are very complex procedures. The hope of these developments is to improve the likelihood of a successful ablation procedure and to allow more patients access to this treatment.

Andrew D'Silva

Matthew Wright

Advances in Imaging for Atrial Fibrillation Ablation

Lumbar myelogram utilizing nonionic contrast is a commonly performed procedure to identify spinal pathology. Complication rates are low. Cerebral edema has been shown to occur following intrathecal injection of ionic contrast; however, no current literature has documented this complication relating to the ubiquitously used nonionic contrast medium. We report a case of a patient who developed malignant cerebral edema following a lumbar myelogram with Isovue-M 300 nonionic water-soluble intrathecal contrast. We believe this is the first reported case of cerebral edema resulting from the use of a nonionic contrast.

Brian C. Kelley

Simon Roh

Philip L. Johnson

Paul M. Arnold

Malignant Cerebral Edema following CT Myelogram Using Isovue-M 300 Intrathecal Nonionic Water-Soluble Contrast: A Case Report

Radiodermatitis is a known complication in patients having undergone radiotherapy. It usually appears 2 to 5 years after irradiation. We are reporting on a case of radiodermatitis that occurred within months after coronary dilatation and stenting. It started with painful swelling, followed by a typical appearance on the skin surface. Histological finding confirmed the diagnosis. However, magnetic resonance imaging showed changes in the subcutaneous tissue extending into the ribs. A radical debridement was performed including removal of a partially necrotic 4th rib. The defect was closed with a latissimus dorsi transposition flap. Our findings are compared with the literature reports.

Borut Banic

Bernhard Meier

Andrej Banic

Christian Weinand

Thoracic Radionecrosis Following Repeated Cardiac Catheterization

<i>Objective</i>. To evaluate rise in impedance during percutaneous radiofrequency thermocoagulation (PRFTC) of osteoid osteomas as a predictor of local recurrence. <i>Design and Patients</i>. A prospective study of 23 patients (24 PRFTC procedures) with minimum of 2.25-year followup (average 3.3 years). Average age 19.6 years (range 4&#8211;44), sex ratio 15&#x02009;:&#x02009;8 (male&#x02009;:&#x02009;female), 16 nondiaphyseal, 7 diaphyseal. <i>Results</i>. In 19 procedures, an increase in impedance was measured&#8212;no recurrences have occurred in this group to date. In 5 procedures, no increase in impedance was seen (3 non-diaphyseal, 2 diaphyseal), and 1 recurrence has been seen in this group to date. This difference is statistically significant with a <i>P</i> value of .05.

Matthew Ockendon

Jonathan J. Gregory

Gillian L. Cribb

W. Paul Cool

D. Charles Mangham

Radhesh Lalam

Osteoid Osteoma: Can Impedance Levels in Radiofrequency Thermocoagulation Predict Recurrence?

<i>Purpose</i>. To evaluate stent lumen visibility of a large sample of different peripheral arterial (iliac, renal, carotid) stents using magnetic resonance angiography in vitro. <i>Materials and Methods</i>. 21 different stents and one stentgraft (10 nitinol, 7 316L, 2 tantalum, 1 cobalt superalloy, 1 PET + cobalt superalloy, and 1 platinum alloy) were examined in a vessel phantom (vessel diameters ranging from 5 to 13&#x2009;mm) filled with a solution of Gd-DTPA. Stents were imaged at 1.5 Tesla using a T1-weighted 3D spoiled gradient-echo sequence. Image analysis was performed measuring three categories: Signal intensity in the stent lumen, lumen visibility of the stented lumen, and homogeneity of the stented lumen. The results were classified using a 3-point scale (good, intermediate, and poor results). <i>Results</i>. 7 stents showed good MR lumen visibility (4x nitinol, 2x tantalum, and 1x cobalt superalloy). 9 stents showed intermediate results (5x nitinol, 2x 316L, 1x PET + cobalt superalloy, and 1x platinum alloy) and 6 stents showed poor results (1x nitinol, and 5x 316L). <i>Conclusion</i>. Stent lumen visibility varies depending on the stent material and type. Some products show good lumen visibility which may allow the detection of stenoses inside the lumen, while other products cause artifacts which prevent reliable evaluation of the stent lumen with this technique.

Matthias C. Burg

Alexander C. Bunck

Harald Seifarth

Boris Buerke

Harald Kugel

Volker Hesselmann

Michael Köhler

Walter Heindel

David Maintz

MR Angiography of Peripheral Arterial Stents: In Vitro Evaluation of 22 Different Stent Types

<i  >Purpose.</i> To evaluate retrospectively the impact of diffusion weighted imaging (DWI) and (3D) hydrogen 1 (<sup  >1</sup>H) MR-spectroscopy (MRS) on the detection of prostatic cancer in comparison to histological examinations. <i  >Materials and Methods:</i> 50 patients with suspicion of prostate cancer underwent a MRI examination at a 1.5T scanner. The prostate was divided into sextants. Regions of interest were placed in each sextant to evaluate the apparent diffusion coefficient (ADC)-values. The results of the DWI as well as MRS were compared retrospectively with the findings of the histological examination. Sensitivity and specificity of ADC and metabolic ratio (MET)&#x2014;both separately and in combination&#x2014;for identification of tumor tissue was computed for variable discrimination thresholds to evaluate its receiver operator characteristic (ROC). An association between ADC, MET and Gleason score was tested by the non-parametric Spearman <svg style="vertical-align:-2.29482pt;width:7.9749999px;" id="M1" height="9.875" version="1.1" viewBox="0 0 7.9749999 9.875" width="7.9749999"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,9.875)">
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				<tspan style="font-size: 12.50px; " x="0" y="0">𝜌</tspan>
			</text>

		</g>
	</g>
</svg>-test. <i  >Results.</i> The average ADC-value was <svg style="vertical-align:-1.09097pt;width:72.474998px;" id="M2" height="12.2375" version="1.1" viewBox="0 0 72.474998 12.2375" width="72.474998"  xmlns="http://www.w3.org/2000/svg">
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				<tspan style="font-size: 12.50px; " x="0" y="0">1</tspan>
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				<tspan style="font-size: 12.50px; " x="24.655916" y="0">±</tspan>
				<tspan style="font-size: 12.50px; " x="35.996136" y="0">0</tspan>
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				<tspan style="font-size: 12.50px; " x="45.373386" y="0">3</tspan>
				<tspan style="font-size: 12.50px; " x="51.624886" y="0">2</tspan>
			</text>

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	</g>
</svg>mm<sup  >2</sup>/s <svg style="vertical-align:-0.3135pt;width:10.125px;" id="M3" height="8.7875004" version="1.1" viewBox="0 0 10.125 8.7875004" width="10.125"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,8.7875)">
		<g transform="translate(72,-64.97)">
			<text transform="matrix(1,0,0,-1,-71.95,65.34)">
				<tspan style="font-size: 12.50px; " x="0" y="0">×</tspan>
			</text>

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	</g>
</svg> 10<sup  >-3</sup> in normal tissue and 0.96&#xb1;0.24 mm<sup  >2</sup>/s <svg style="vertical-align:-0.3135pt;width:10.125px;" id="M4" height="8.7875004" version="1.1" viewBox="0 0 10.125 8.7875004" width="10.125"  xmlns="http://www.w3.org/2000/svg">
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				<tspan style="font-size: 12.50px; " x="0" y="0">×</tspan>
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</svg> 10<sup  >-3</sup> in tumor tissue (mean <svg style="vertical-align:-1.09097pt;width:10.825px;" id="M5" height="9.3249998" version="1.1" viewBox="0 0 10.825 9.3249998" width="10.825"  xmlns="http://www.w3.org/2000/svg">
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</svg> 1 SD). MET was <svg style="vertical-align:-1.09097pt;width:88.112503px;" id="M6" height="12.05" version="1.1" viewBox="0 0 88.112503 12.05" width="88.112503"  xmlns="http://www.w3.org/2000/svg">
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		<g transform="translate(72,-62.36)">
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				<tspan style="font-size: 12.50px; " x="9.3772497" y="0">4</tspan>
				<tspan style="font-size: 12.50px; " x="15.62875" y="0">1</tspan>
				<tspan style="font-size: 12.50px; " x="21.880251" y="0">8</tspan>
				<tspan style="font-size: 12.50px; " x="30.907415" y="0">±</tspan>
				<tspan style="font-size: 12.50px; " x="42.247639" y="0">0</tspan>
				<tspan style="font-size: 12.50px; " x="48.499138" y="0">.</tspan>
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				<tspan style="font-size: 12.50px; " x="64.127884" y="0">1</tspan>
			</text>

		</g>
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</svg> in normal tissue and <svg style="vertical-align:-1.09097pt;width:93.3125px;" id="M7" height="12.175" version="1.1" viewBox="0 0 93.3125 12.175" width="93.3125"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,12.175)">
		<g transform="translate(72,-62.26)">
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				<tspan style="font-size: 12.50px; " x="21.880251" y="0">0</tspan>
				<tspan style="font-size: 12.50px; " x="35.070915" y="0">±</tspan>
				<tspan style="font-size: 12.50px; " x="46.411137" y="0">1</tspan>
				<tspan style="font-size: 12.50px; " x="52.662636" y="0">.</tspan>
				<tspan style="font-size: 12.50px; " x="55.788387" y="0">6</tspan>
				<tspan style="font-size: 12.50px; " x="62.039886" y="0">4</tspan>
				<tspan style="font-size: 12.50px; " x="68.291389" y="0">9</tspan>
			</text>

		</g>
	</g>
</svg> in tumor tissue. The area under the ROC curve was 0.966 (95&#x25;-confidence interval 0.941&#x2013;0.991) and 0.943 (0.918&#x2013;0.968) for DWI and MRS, respectively. There was a highly significant negative correlation between ADC-value and the Gleason score in the tumor-positive tissue probes (<svg style="vertical-align:-0.17555pt;width:42.912498px;" id="M8" height="11.0375" version="1.1" viewBox="0 0 42.912498 11.0375" width="42.912498"  xmlns="http://www.w3.org/2000/svg">
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				<tspan style="font-size: 12.50px; " x="0" y="0">𝑛</tspan>
				<tspan style="font-size: 12.50px; " x="9.6773224" y="0">=</tspan>
				<tspan style="font-size: 12.50px; " x="21.71771" y="0">6</tspan>
				<tspan style="font-size: 12.50px; " x="27.969212" y="0">2</tspan>
			</text>

		</g>
	</g>
</svg>, <svg style="vertical-align:-2.29482pt;width:73.224998px;" id="M9" height="13.7375" version="1.1" viewBox="0 0 73.224998 13.7375" width="73.224998"  xmlns="http://www.w3.org/2000/svg">
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				<tspan style="font-size: 12.50px; " x="52.225033" y="0">5</tspan>
			</text>

		</g>
	</g>
</svg>, <svg style="vertical-align:-0.17555pt;width:56.150002px;" id="M10" height="10.9125" version="1.1" viewBox="0 0 56.150002 10.9125" width="56.150002"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,10.9125)">
		<g transform="translate(72,-63.27)">
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				<tspan style="font-size: 12.50px; " x="22.930502" y="0">.</tspan>
				<tspan style="font-size: 12.50px; " x="26.056252" y="0">0</tspan>
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				<tspan style="font-size: 12.50px; " x="38.559254" y="0">1</tspan>
			</text>

		</g>
	</g>
</svg>). MRS did not show a significant correlation with the Gleason score (<svg style="vertical-align:-2.29482pt;width:62.525002px;" id="M11" height="13.55" version="1.1" viewBox="0 0 62.525002 13.55" width="62.525002"  xmlns="http://www.w3.org/2000/svg">
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		<g transform="translate(72,-61.16)">
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				<tspan style="font-size: 12.50px; " x="21.780226" y="0">0</tspan>
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				<tspan style="font-size: 12.50px; " x="31.157476" y="0">1</tspan>
				<tspan style="font-size: 12.50px; " x="37.408978" y="0">1</tspan>
				<tspan style="font-size: 12.50px; " x="43.660477" y="0">7</tspan>
			</text>

		</g>
	</g>
</svg>, <svg style="vertical-align:-0.17555pt;width:56.150002px;" id="M12" height="11.0375" version="1.1" viewBox="0 0 56.150002 11.0375" width="56.150002"  xmlns="http://www.w3.org/2000/svg">
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		<g transform="translate(72,-63.17)">
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				<tspan style="font-size: 12.50px; " x="22.930502" y="0">.</tspan>
				<tspan style="font-size: 12.50px; " x="26.056252" y="0">3</tspan>
				<tspan style="font-size: 12.50px; " x="32.307751" y="0">6</tspan>
				<tspan style="font-size: 12.50px; " x="38.559254" y="0">6</tspan>
			</text>

		</g>
	</g>
</svg>). By using both the DWI and MRS, the regression model provided sensitivity and specificity for detection of tumor of 91.9&#x25; and 98.3&#x25;, respectively. <i  >Conclusion.</i> The results of our study showed that both DWI and MRS should be considered as an additional and complementary tool to the T2-weighted MRI for detecting prostate cancer. 


J. Yamamura

G. Salomon

R. Buchert

A. Hohenstein

J. Graessner

H. Huland

M. Graefen

G. Adam

U. Wedegaetner

MR Imaging of Prostate Cancer:  Diffusion Weighted Imaging and (3D) Hydrogen 1 (<sup>1</sup>H) MR Spectroscopy in Comparison with Histology

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<p><em>Radiology Research and Practice</em> publishes articles on all areas of medical imaging. The journal promotes evidence-based radiology practice though the publication of original research and&nbsp;reviews for a multidisciplinary audience.</p>


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Radiology Research and Practice | Hindawi

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Radiology Research and Practice publishes articles on all areas of medical imaging. The journal promotes evidence-based radiology practice though the publication of original research and reviews for a multidisciplinary audience.

Radiology Research and Practice