European journal of radiology

Publisher: Elsevier

Current impact factor: 2.37

Impact Factor Rankings

2015 Impact Factor Available summer 2016
2014 Impact Factor 2.369
2013 Impact Factor 2.16
2012 Impact Factor 2.512
2011 Impact Factor 2.606
2010 Impact Factor 2.941
2009 Impact Factor 2.645
2008 Impact Factor 2.339
2007 Impact Factor 1.915
2006 Impact Factor 1.332
2005 Impact Factor 1.888
2004 Impact Factor 1.745
2003 Impact Factor 1.06
2002 Impact Factor 1.118
2001 Impact Factor 1.084
2000 Impact Factor 0.822
1999 Impact Factor 0.574
1998 Impact Factor 0.537
1997 Impact Factor 0.537
1996 Impact Factor 0.358
1995 Impact Factor 0.449
1994 Impact Factor 0.418
1993 Impact Factor 0.41
1992 Impact Factor 0.308

Impact factor over time

Impact factor

Additional details

5-year impact 2.41
Cited half-life 4.40
Immediacy index 0.40
Eigenfactor 0.03
Article influence 0.76
ISSN 1872-7727

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Publications in this journal

  • European journal of radiology 12/2015; 84(12):2345-2346. DOI:10.1016/j.ejrad.2015.11.013
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    ABSTRACT: Purpose: To assess T2 HASTE MR in acute abdominal imaging and ascertain if it is a reliable alternative to CT in patients under 60. Method and materials: In a prospective diagnostic performance study from January 2009 to December 2013, patients under 60 presenting with acute abdominal pain, that required imaging following surgical review, were imaged with T2 HASTE MR. Rapid acquisition HASTE (Half Fourier Acquisition Single Shot Turbo Spin Echo) coronal and axial sequences were obtained, without intravenous contrast. Patients were followed up clinically for a minimum of 3 months. Results: 468 cases included in the study. 349 were negative for acute abdominal pathology, 116 positive for acute abdominal pathology and 3 were indeterminate. In the MR positive group (n=116), 64 had surgery confirming findings (34 appendicitis, 14 SBO, 3 ovarian torsion, 3 LBO, intussusception, ovarian carcinoma, ovarian dermoid, 2 pelvic inflammatory disease, diverticular abscess, crohns, 4 endoscopy for acute bowel pathology) while 51 were managed conservatively with concordant follow up (4 SBO, 11 diverticulitis, 6 pelvic inflammatory disease, 7 inflammatory bowel disease, 7 colitis, 6 pyelonephritis, 2 cholecystitis, renal abscess, pseudomembranous colitis, splenic haematoma, mesenteric adenitis, 2 pancreatitis, lymphoma, epiploic appendagitis). 1 patient had an MR diagnosis of appendicitis but at laparoscopy a sigmoid diverticular perforation was diagnosed and the appendix was normal. In the MR negative group (n=349), 324 had uneventful follow-up, 22 had negative laparoscopies, while 3 had subsequent appendectomies, with appendicitis on histology (3 days, 10 days and 2 months post scan). In the MR indeterminate group (n=3), one was treated conservatively with uneventful follow up, one had laparoscopic appendectomy with normal appendix on histology, one had laparoscopic appendectomy with acute appendicitis on histology. When MR correlated with clinical follow up (n=468), overall diagnostic accuracy is 99% (463/468). When MR findings correlated with direct visualisation at surgery/endoscopy (n=90), sensitivity is 98% (95% CI) and specificity is 92% (95% CI). Conclusion: This study demonstrates that rapid acquisition axial and coronal T2 HASTE MR is a practical, safe and effective method in the diagnosis of acute abdominal pain. MR is the preferred option to CT in patients of an age prone to radiation with a potential surgical diagnosis. Clinical relevance/application: MRI in acute abdominal imaging is both effective and practical and is the preferred imaging option in patients of an age prone to radiation with a potential surgical diagnosis.
    European journal of radiology 11/2015; DOI:10.1016/j.ejrad.2015.10.002
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    ABSTRACT: Purpose: To compare radiation dose, image quality and diagnostic performance of low dose CT enterography (CTE) protocol combined with iterative reconstruction algorithm (iDose(4)) with standard dose CTE in follow-up of patients with known Crohn's disease (CD). Materials and method: Thirty-six patients (12 females), with CD underwent a low-dose CTE scan during single venous phase on 256 MDCT scanner, with the following parameters: 120kV, automated mAs dose-modulation, slice thickness 2mm and iDose(4) iterative reconstruction algorithm. A control group of thirty-seven patients underwent standard dose CTE examination on the same CT scanner. Two radiologists, blinded to clinical and pathological findings, independently evaluated in each scan, HU values in bowel wall and any presence of CD activity features and disease complications. Image noise and diagnostic quality were evaluated using a 4-point scale. Dose-length product (DLP) and CT-dose-index (CTDI) were recorded and data from both examinations were compared and statistically analyzed. Results: Low-dose CTE protocol showed high diagnostic quality in assessment of Crohn's disease obtaining significantly (p≤0.001) lower values of DLP and CTDI (604.98mGy*cm and 12.29mGy) as compared to standard dose examinations (974.85mGy*cm and 19.71mGy), with an overall dose reduction of 37.6%. Noise resulted slightly higher in iDose(4) images (SD=15.97) than in standard dose ones (SD=13.61) but this difference was not statistically significant (p=0.064). Conclusion: Low-dose CTE combined with iDose(4) reconstruction algorithm offers high quality images with significant reduction of radiation dose, and therefore can be considered a useful tool in the management of CD patients, considering their young age and the frequent imaging follow-up required.
    European journal of radiology 11/2015; DOI:10.1016/j.ejrad.2015.10.011
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    ABSTRACT: Purpose: To determine the prognostic performance of tumor necrosis at FDG-PET in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) who are treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy. Materials and methods: 108 patients with newly diagnosed DLBCL who underwent FDG-PET before R-CHOP therapy were retrospectively included. Lymphomatous sites at FDG-PET were assessed for the presence of a photopenic area, in keeping with tumor necrosis. Univariate and multivariate Cox regression analyses were performed to determine the associations of tumor necrosis and National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) with progression-free survival (PFS) and overall survival (OS). Results: On univariate Cox regression analysis, both tumor necrosis and higher NCCN-IPI risk groups were significantly associated with PFS (P=0.024 and P<0.001, respectively) and OS (P=0.034 and P<0.001, respectively). On multivariate Cox regression analysis, both tumor necrosis and the NCCN-IPI were independent significant predictors for PFS (P=0.007, hazard ratio: 2.723 [95% confidence interval: 1.324-5.597] and P<0.001, hazard ratio: 2.952 [95% confidence interval: 1.876-4.646], respectively) and OS (P=0.009, hazard ratio: 2.794 [95% confidence interval: 1.305-5.985] and P<0.001, hazard ratio: 2.813 [95% confidence interval: 1.724-4.587], respectively). Conclusion: Tumor necrosis at FDG-PET is an NCCN-IPI-independent predictor of outcome in DLBCL.
    European journal of radiology 10/2015; DOI:10.1016/j.ejrad.2015.09.016
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    ABSTRACT: Objective: To compare the value of MRI diffusion kurtosis imaging (DKI) and diffusion tensor imaging (DTI) in differentiating high-grade-astrocytomas from solitary-brain-metastases. Methods: Thirty-one high-grade-astrocytomas and twenty solitary-brain-metastases were retrospectively identified. DKI parameters [mean kurtosis (MK), radial kurtosis (Kr), and axial kurtosis (Ka)] and DTI parameters [fractional anisotropy (FA) and mean diffusivity (MD)] values with and without correction by contralateral normal-appearing white matter (NAWM) in the tumoral solid part and peritumoral edema, were compared using the t-test. Receiver operating characteristic (ROC) curves were used to test for the best parameters. Results: The DKI values (MK, Kr, and Ka) and DTI values (FA and MD) in tumoral solid parts did not show significant differences between the two groups. Corrected and uncorrected MK, Kr, and Ka values in peritumoral edema were significantly higher in high-grade-astrocytomas than solitary-brain-metastases, and MD values without correction were lower in high-grade astrocytomas than solitary-brain-metastases. The areas under curve (AUC) of corrected Ka (1.000), MK (0.889), and Kr (0.880) values were significantly higher than those of MD (0.793) and FA (0.472) values. The optimal thresholds for corrected MK, Kr, Ka, and MD were 0.369, 0.405, 0.483, and 2.067, respectively. Conclusion: DKI and directional analysis could lead to improved differentiation with better sensitivity and directional specificity than DTI.
    European journal of radiology 10/2015; 84(12). DOI:10.1016/j.ejrad.2015.10.007
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    ABSTRACT: Objectives: To compare fat-saturated T2-weighted (FST2W) with contrast-enhanced fat-saturated T1-weighted (cFST1W) pulse sequences in magnetic resonance (MR) imaging of sacroiliac joints in diagnosis of active sacroiliitis associated with axial spondyloarthropathies. Materials and methods: MR examinations of 147 adult patients suspected for sacroiliitis were retrospectively analyzed. Signs of active inflammation, bone marrow edema/osteitis, capsulitis, enthesitis, and synovitis were noted both on FST2W and cFST1W images. Diagnosis of active sacroiliitis was made according to the Assessment in SpondyloArthritis international Society (ASAS) definition. Results: Sixty three patients were diagnosed as having active sacroiliitis based on both FST2W images showing bone marrow edema and cFST1W images showing osteitis. All areas with osteitis seen on cFST1W images were also noted as having bone marrow edema on FST2W images while FST2W images revealed 4 additional areas of active bone marrow changes. Qualitative and quantitative analyses also revealed that FST2W images were superior in showing active bone marrow lesions, the hallmark of active sacroiliitis, while cFST1W images helped detecting enthesitis and/or capsulitis and were necessary for detecting synovitis. Conclusion: Although cFST1W images help detecting enthesitis and/or capsulitis and are necessary for detecting synovitis, FST2W sequence is superior in detecting active bone marrow lesions and therefore more valuable in diagnosing active sacroiliitis associated with axial spondyloarthropathies based on ASAS criteria.
    European journal of radiology 10/2015; 84(12). DOI:10.1016/j.ejrad.2015.08.021
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    ABSTRACT: Purpose: To retrospectively evaluate the incidence of each extrahepatic collateral artery (EHCA) supplying to hepatocellular carcinoma (HCC) in sessions of transcatheter arterial chemoembolization (TACE) and its therapeutic frequency. Materials and methods: Between February 2002 and May 2008, 182 patients with HCC underwent TACE and survived more than 3 years. For TACE procedure, angiographic evaluation of all suspected EHCAs that could supply the tumor were performed. The incidence of EHCAs in TACE sessions and therapeutic frequency were analyzed. Correlations between the number of collaterals and the number of TACE sessions were investigated. Results: 162 patients showed 647 EHCAs supplying tumors in a total of 795 sessions of TACE. The initially confirmed EHCAs in TACE sessions were the right inferior phrenic artery (RIPA, n=150), left inferior phrenic artery (LIPA, n=8), right internal mammary artery (RIMA, n=4), right adrenal artery (RAA, n=2) and left gastric artery (LGA, n=5), respectively. The incidences of EHCAs were 51.1%, 68.1%, 50.0%, 50.0%, 42.3%, 34.6%, 29.1%, 19.8%, 6.6%, 3.3% and 0.6% from 1 to 11 session of TACE, respectively. The RIPA was accounted for 62.5% of EHCAs and other EHCAs often occurred after the attenuation of RIPA. There were correlations between the number of TACE sessions and either the sum number of collaterals (r=-0.961; p<0.001), the number of RIPA(r=-0.948; p<0.001) or the number of LGA(r=-0.670; p=0.024). The mean therapeutic frequencies of TACE were 2.6, 1.5, 1.6, 1.3, 1.5, 1.2, 3.3, 1.1, 1.0 and 7.0 times for the RIPA, LIPA, RIMA, left internal mammary artery (LIMA), omental artery (OMA), LGA, right intercostal artery (RICA), RAA, right renal capsular artery (RRCA) and colic artery (COA), respectively. Conclusions: The RIPA angiography should be routinely performed in TACE procedure. EHCAs should be searched during the sessions of TACE in the following order: RIPA, RIMA, LIPA and other collaterals of lower incidence.
    European journal of radiology 10/2015; 84(12). DOI:10.1016/j.ejrad.2015.10.006
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    ABSTRACT: Aim: To describe the presence of atypical calcifications on post-operative mammography after breast-conserving surgery (BCS) and intraoperative radiotherapy (IORT). Materials and methods: We retrospectively include all patients followed after BCS and IORT for breast cancer (n=271). All follow-up mammograms at 6 months after surgery were retrospectively evaluated by two board-certified radiologists. The radiologists had to notify the presence or the absence of atypical calcifications. Results: Five patients had on follow-up mammography the presence of atypical calcifications. Two patients had a stereotactic breast biopsy. The pathologic examination showed the presence of small tungsten particles located in the breast parenchyma. Conclusion: The presence of atypical calcifications after BCS and IORT, presenting as multiple, scattered, round calcifications, should be rated as BIRADS 2 and do not require biopsy. They corresponded on tungsten deposits.
    European journal of radiology 10/2015; 84(12). DOI:10.1016/j.ejrad.2015.10.004
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    ABSTRACT: Purpose: Clinically palpable lymph nodes (CPLN) are usually considered a contraindication to sentinel lymph node biopsy (SLNB) but one third of these patients are node negative. The aim of the present study is to evaluate the clinical usefulness of combining SLNB and preoperative axillary ultrasonography (AUS) with FNAC in patients with clinically palpable but indeterminate axillary lymph nodes. Materials and methods: Fifty three patients with primary breast cancer and CPLN (mean age, 51.6 years; median age 51years; age range, 28-73 years) were included in the study. All patients underwent AUS and fine needle aspiration (FNAC) followed by SLNB in FNAC negative patients (Group A). Patients with proven metastasis subsequently had axillary lymph node dissection (ALND) (Group B). Standard SLN scintigraphy was performed 2-4h before surgery by injecting Tc-99m labeled nano-colloid intra-dermally in the periareolar region. Results: Nodal metastases were documented at FNAC in 26 (49%) of the 53 patients with subsequent ALND (Group B). All 27 patients (51%) with negative FNAC results (Group A) underwent SLNB, which revealed metastasis in 6 (11%) patients. The remaining 21 (40%) patients were tumor negative and all these patients remain disease free during the follow-up period of 12-36 months with NPV of 100%. SLN was identified in all patients (100% success rate). Preoperative AUS sensitivity was 78%, specificity 76%, PPV 83%, NPV 69% and accuracy 77% (p=0.001). In comparison, ultrasound guided FNAC sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 81%, 100%, 100%, 78%, 89% respectively (p=0.001). Conclusions: The inaccuracy of clinical assessment allows widening of indication of SLNB. Preoperative ultrasonography and guided FNAC can help in selecting the patients suitable for ALND or SLNB. Patients who are FNAC positive can proceed to ALND whilst FNAC negative samples can undergo SLNB. This combination strategy may be helpful in avoiding unnecessary ALND.
    European journal of radiology 10/2015; 84(12). DOI:10.1016/j.ejrad.2015.10.003
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    ABSTRACT: Objectives: To determine whether lesion stiffness measured by shear-wave elastography (SWE) can be used to predict the histologic underestimation of ultrasound (US)-guided 14-gauge core needle biopsy (CNB) for breast masses. Methods: This retrospective study enrolled 99 breast masses from 93 patients, including 40 high-risk lesions and 59 ductal carcinoma in situ (DCIS), which were diagnosed by US-guided 14-gauge CNB. SWE was performed for all breast masses to measure quantitative elasticity values before US-guided CNB. To identify the preoperative factors associated with histologic underestimation, patients' age, symptoms, lesion size, B-mode US findings, and quantitative SWE parameters were compared according to the histologic upgrade after surgery using the chi-square test, Fisher's exact test, or independent t-test. The independent factors for predicting histologic upgrade were evaluated using multivariate logistic regression analysis. Results: The underestimation rate was 28.3% (28/99) in total, 25.0% (10/40) in high-risk lesions, and 30.5% (18/59) in DCIS. All elasticity values of the upgrade group were significantly higher than those of the non-upgrade group (P<0.001). On multivariate analysis, the mean (Odds ratio [OR]=1.021, P=0.001), maximum (OR=1.015, P=0.008), and minimum (OR=1.028, P=0.001) elasticity values were independently associated with histologic underestimation. The patients' age, lesion size, and final assessment category on US of the upgrade group were higher than those of the non-upgrade group (P=0.046 for age; P=0.021 for lesion size; P=0.030 for US category), but these were not independent predictors of histologic underestimation on multivariate analysis. Conclusion: Breast lesion stiffness quantitatively measured by SWE could be helpful to predict the underestimation of malignancy in US-guided 14-gauge CNB.
    European journal of radiology 10/2015; 84(12). DOI:10.1016/j.ejrad.2015.10.001
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    ABSTRACT: Purpose: This study aimed to evaluate the prognostic value of pretreatment (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in pediatric neuroblastoma patients. Methods: The study included 50 pediatric neuroblastoma patients who underwent diagnostic work-up FDG PET before any treatment. The maximum standardized uptake value (SUVmax) of the primary tumor lesion (Pmax), the SUVmax of all the tumor lesions, including the primary tumor lesion and metastatic lesions (Tmax), and the uptake ratio of Tmax to mean SUV of normal liver tissue (Tmax/Lmean) were calculated and tested as prognostic factors. Results: Of the 50 patients, 15 (30.0%) experienced disease progression and 21 (42.0%) died during the follow-up period. On univariate analysis, the histopathology, tumor stage, bone marrow involvement, serum levels of lactate dehydrogenase (LDH), neuron-specific enolase, and ferritin, primary tumor size, Pmax, Tmax, and Tmax/Lmean were significant prognostic factors for disease progression-free survival (PFS), whereas the tumor stage, serum level of LDH, Tmax, and Tmax/Lmean were determined to be significant for predicting overall survival (OS). On multivariate analysis, the histopathology and serum level of LDH were independent prognostic factors for PFS, and only the Tmax/Lmean was an independent prognostic factor for OS. The 2-year PFS and OS rates were over 80.0% in patients with low FDG uptake, meanwhile, patients with high FDG uptake showed the 2-year PFS of less than 30.0% and OS of less than 55.0%. Conclusion: FDG PET was an independent prognostic factor for OS in neuroblastoma patients. FDG PET can provide effective information on the prognosis for neuroblastoma patients.
    European journal of radiology 10/2015; 84(12). DOI:10.1016/j.ejrad.2015.09.027
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    ABSTRACT: Objective: To compare tumor volume reduction rate (TVRR) measured by MR volumetry after preoperative chemoradiotherapy (CRT) and pathological tumor regression grade (TRG) in locally advanced rectal cancer (LARC). Material and methods: In total, 20 patients with LARC (cT3-T4) treated with CRT followed by Total Mesorectal Excision (TME) between April 2011 and April 2013 were analyzed retrospectively. Pre- and post- CRT tumor volumes (MR volumetry) were measured on 3D MR sequences. TVRR was determined using the equation TVRR (%)=(pre-CRT tumor volume-post-CRT tumor volume)×100/pre-CRT tumor volume. The downstaging (defined as ypT0-T2) of tumor mass was evaluated and the correlation between TVRR and TRG was calculated with the method proposed by Dworak using the Spearman rank test. Results: The median TVRR was 77.3% (range, 26.4-99.3%); TVRR was >60% in 18 cases (90%) and in 8 of these patients (44.4 %) it was >80%. Downstaging of tumor lesions was obtained in 15 patients (75%). In 4 cases there was a complete tumor regression (TRG4) at histological examination and in the same patients there was also a TVRR>80% measured by MR volumetry. A statistically significant correlation between TVRR and TRG (rs=0.5466, p=0.0126) was observed. Conclusion: TVRR after preoperative CRT correlates with TRG in LARC. The MR volumetry is a prognostic factor to estimate the tumor response after preoperative CRT. TVRR data may be an useful biomarker for tailoring surgery and postoperative adjuvant chemotherapy.
    European journal of radiology 10/2015; 84(12). DOI:10.1016/j.ejrad.2015.08.008
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    ABSTRACT: Introduction: Gadoxetate disodium is a gadolinium-based contrast agent (GBCA) typically used for body imaging, as about 50% of its excretion is via the liver. Its use for craniospinal MRI has not been reported. Materials and methods: Over a 3 years period, 31 adults underwent postcontrast MRI using gadoxetate disodium, each of whom had a relative contraindication to a GBCA, but a GBCA was deemed necessary by the clinical service to direct therapy. Postcontrast T1WI included either gradient-echo (GET1WI, n=12) or spin-echo (SET1WI, n=13) imaging. The contraindication in 29 patients was stage 3-5 chronic kidney disease (CKD) or acute kidney injury (AKI); the other two had normal kidney function, but a history of a reaction to another GBCA (vomiting in one and hypersensitivity in the other). Over a 3 years period, in those patients in whom a GBCA was both deemed necessary and had an estimated GFR (eGFR) of <40ml/min/1.73m(2) (i.e., stage 3-5 CKD), both informed consent and nephrology consultation was obtained. A 10ml dose was given for cranial (n=23), spinal (n=9), and neck/face MRI (n=3), as well as craniocervical MRA (n=6). Three neuroradiologists separately evaluated for normal enhancement in 11 structures. The contrast enhancing percentage (CE%) was measured in 3 structures, and in enhancing lesions, if present. Results: The pre-MRI eGFR was not significantly different from that at 30-90 days (p=0.522) in the 23 patients with an available eGFR at >90 days post-MRI; no patients developed acute kidney injury post-MRI, nor nephrogenic systemic fibrosis. Of the 11 intracranial structures scored, the superior sagittal sinus, pituitary stalk, and atrial choroid plexus enhanced in all 23 patients who underwent brain MRI, with CE%'s of 171.0%, 73.0%, and 69.8%, respectively. The number of patients with enhancing lesions were 3/23 brain MRI's, 8/9 spinal MRI's, 3/3 neck MRI's, and 2/6 craniocervical MRA/MRV's. In 9 spinal MRI's, the basivertebral plexus CE% was 213.7%; in the 7 with spondylodiscitis, the CE% measured 125.8% in enhancing epidural tissue, with a contrast-to-noise ratio (CNR) of 98.0%. Conclusion: This preliminary report describes the use of gadoxetate disodium as an alternative GBCA for craniospinal MRI and MRA in the renally impaired, but its efficacy in this regard must be further evaluated prospectively.
    European journal of radiology 10/2015; 84(12). DOI:10.1016/j.ejrad.2015.09.004
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    ABSTRACT: Objective: Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths. Cell proliferativity and hypoxia have important impact on the response to radiotherapy or chemotherapy. The purpose of this study was to investigate the association of apparent diffusion coefficient (ADC) values and the molecular markers Ki-67 and hypoxia inducible factor-α (HIF-α) in hepatocellular carcinoma (HCC). Materials and methods: Forty-seven patients diagnosed with HCC were included in this study. All patients performed diffusion-weighted magnetic resonance imaging (DW-MRI) before any anticancer treatment. The ADC maps were automatically calculated on a Syngo workstation. The Ki-67 and HIF-1α expression were assessed by immunohistochemistry. The Pearson correlation test was used to assess the correlation between ADC values and Ki-67 and HIF-1α expression. Results: Ki-67 staining was clearly identified based on the brown nuclear staining in tumor cells. High Ki-67 expression was correlated with low differentiation (p=0.028). A significant correlation was observed between HIF-1α expression and maximum diameter (p=0.014). The mean ADC value was (0.983±0.21)×10(-3)mm(2)/s. The level of Ki-67 expression was correlated inversely with the ADC values (r=-0.371, p=0.01). There was a significant positive correlation between the ADC values and HIF-1α expression (r=0.389, p=0.007). Conclusion: The ADC values were observed to correlate significantly with the molecular markers Ki-67 and HIF-1α. Our results suggest that the ADC values on DW-MRI may be used as a measure of cell proliferativity and hypoxia in hepatocellular carcinoma.
    European journal of radiology 10/2015; 84(12). DOI:10.1016/j.ejrad.2015.09.013
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    ABSTRACT: Objectives: To semi-quantitatively assess expiratory air trapping (ATexp) and structural changes in the proximal airways in asthma during asthma exacerbation (AE) and to explore the relationships among ATexp, clinical indices, and proximal airway changes. Methods: Paired inspiratory-dynamic forced expiratory CT scans of 36 asthmatics (30 women, 6 men; mean age, 49.2±18.9 years) performed during AE were retrospectively reviewed for the total ATexp score (summed scores [extent grading (0-4)×pattern grading (1-4)] of the twelve lung zones), morphologic parameters and expiratory bronchial collapse (BCexp) of the proximal airways. The relationships of the score with clinical indices and proximal airway morphology (normalized by body surface area [BSA]) were analyzed. A p value of p <0.05 was considered statistically significant. Results: The mean total ATexp score was 110.1±43.4 (range, 8-166). It was higher in the lower zones and in patients older than 60 years, having BMI of <27.5kg/m(2), and peak expiratory flow rate (PEFR) of <60% predicted. Correlation existed between the score and age (r=0.331), BMI (r=-0.375), BSA (r=-0.442), % predicted PEFR (r=-0.332), right upper lobe apical segmental bronchus (RB1)-wall area (WA)/BSA (r=0.467), %RB1-WA (r=0.395), and RB1-bronchial wall thickness (BWT)/BSA (r=0.378). The score showed no correlation with BCexp and other morphologic bronchial parameters. Area under receiver-operating-characteristic curve 0.724 (95% CI) showed that the score of 110 could discriminate patients with PEFR of <60% predicted from those with PEFR of ≥60% predicted. Conclusion: During AE, there was a high prevalence of extensive ATexp which was correlated with patient's age, BMI, BSA, AE severity and RB1 morphology but not correlated with BCexp.
    European journal of radiology 10/2015; 84(12). DOI:10.1016/j.ejrad.2015.09.008
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    ABSTRACT: Objective: Response monitoring of transarterial chemoembolization (TACE) with the help of volume perfusion computed tomography (VPCT) at day one post-TACE and analysis of TACE-impact on tumor and uninvolved liver parenchymal perfusion by using different particles sizes and epirubicin dose. Materials and methods: Institutional review board approved this prospective study. VPCT was performed in the baseline, post-interventional (FU1; 24h post-TACE) and at follow-up (FU2; median, 81 days) in 45 consecutive patients. 100-300μm (n=17) and 300-500μm (n=28) drug eluting beads (DEB) using an epirubicin dose of (<=25vs. >25) were administered. VPCT was performed for 40-s using 80kV, 100/120mAs, 64×0.6mm collimation, 26 consecutive measurements, IV injection (50ml iodinated contrast), flow rate (5ml/s). Blood flow (BF), blood volume (BV) and k-trans were registered as average and max values in the tumor. Arterial liver perfusion (ALP), portal-venous perfusion (PVP) and the hepatic perfusion index (HPI) were registered both in tumor and non-involved liver parenchyma. Response to TACE was classified by VPCT as complete (CR), partial (PR) or no response (NR). Results: A significant reduction of viable tumor tissue was found in all patients between baseline and FU1 (p<0.001) being independent on particle size and epirubicin dose (p>0.05). PPV/NPV/sensitivity/specificity of post-interventional VPCT (FU1) results for prediction of the mid-term tumor course (FU2) were 100%/70%/76%/100%. There was generally a significant increase of the ALP between baseline and FU1 in the liver parenchyma coupled by a significant subsequent decrease (normalization) of ALP and HPI between FU1 and FU2. CONCLUSION: VPCT accurately measures impact of TACE on liver tumor and hepatic parenchymal perfusion. The former proved not to be significantly dependent on particle size and epirubicin dose. There was no persistent perfusion deficit in the liver after TACE.
    European journal of radiology 10/2015; 84(12). DOI:10.1016/j.ejrad.2015.09.009
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    ABSTRACT: Aim: To establish proposal ultrasound parotid imaging reporting and data system (PIRADS) for classification and prediction of malignancy of parotid lesions and to assess the inter-observer agreement of this system. Subjects and methods: Retrospective analysis of ultrasound and power Duplex images of 142 patients with parotid lesions by two reviewers. Parotid focal lesions were classified into nine patterns and then categorized into five groups: PIRADS 1, definitively benign; PIRADS 2, probably benign; PIRADS 3, indeterminate; PIRADS 4, probably malignant; and PIRADS 5, highly suggestive malignant. The results: There was excellent interobserver agreement of both reviewers for patterns and PIRADS (K=0.84, P=0.001) with 92% percent agreement. There was excellent agreement of PIRADS 1 (K=1.00, P=0.001), PIRADS 2 (K=0.97, P=0.001), PIRADS 3 (K=0.86, P=0.001) and PIRADS 5 (K=0.88, P=0.001) and good agreement of PIRADS 4 (K=0.67, P=0.001). The Odds ratio of PIRADS 3, 4 and 5 were 1.36 (95% CI=0.39-4.55), 7.11 (95% CI=3.02-11.15) and 8.27 (95% CI=3.49-10.27) respectively. The accuracy was 92% and 90%, sensitivity was 79% and 65%, specificity was 94% and 96% of PIRADS of both reviewers respectively. Conclusion: The proposed PIRADS is a reliable non-invasive imaging modality that can be used for categorizing parotid lesions and prediction of malignancy.
    European journal of radiology 10/2015; 84(12). DOI:10.1016/j.ejrad.2015.09.001