European journal of radiology

Publisher: Elsevier

Journal description

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

Publisher details


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    • Publisher last reviewed on 03/06/2015
  • Classification
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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: (1) To evaluate the ability of emergency room radiologists to detect acute mesenteric ischemia (AMI) from computed tomography (CT) images in patients with acute abdominal pain. (2) To identify factors affecting radiologists' performance in the CT interpretation and patient outcome. Materials and methods: A retrospective study of 95 consecutive patients treated for 97 AMI events between 2009 and 2013 was carried out. The etiology of AMI was embolism in 24 (25%), atherosclerotic vascular disease (ASVD) in 39 (40%), non-obstructive mesenteric ischemia (NOMI) in 25 (26%), and mesenteric venous thrombosis (MVT) in nine (9%) cases. The protocols, referrals and initial radiology reports of the abdominal CTs were analyzed. The CT studies were further scrutinized for vascular and intestinal findings. Results: The referring clinician had suspected AMI in 30 (31%) cases prior to imaging. The crucial findings of AMI had been stated in 97% of the radiology reports if the clinician had mentioned AMI suspicion in the referral; if not, the corresponding rate was 81% (p=0.04). Patients without suspicion of AMI prior to CT were more prone to undergo bowel resection. CT protocol was optimal for AMI (with contrast enhancement in arterial and venous phases) in only 34 (35%) cases. Intestinal findings were more difficult to detect than vascular findings. Vascular findings were retrospectively detectable in 92% of cases with embolism and 100% in ASVD and MVT. Some evidence of intestinal abnormality was retrospectively found in the CT findings in 92%, 100%, 100% and 67% of cases with embolism, ASVD, NOMI and MVT, respectively. Conclusions: AMI is underdiagnosed in the CT of the acute abdomen if there is no clinical suspicion.
    European journal of radiology 09/2015; DOI:10.1016/j.ejrad.2015.09.006
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    ABSTRACT: Objective: To investigate dynamic susceptibility contrast (DSC) perfusion weighted imaging (PWI) in white matter lesions (WML) in patients with multiple sclerosis (MS), using automatically generated binary masks of brain tissue. Background: WML in MS have in some studies demonstrated perfusion abnormalities compared to normal appearing white matter (NAWM), however perfusion changes in WML in MS have in general not been well documented. Methods: DSC PWI was performed at 1.5 Tesla in 69 newly diagnosed MS patients. Parametric perfusion maps representing cerebral blood volume (CBV), cerebral blood flow (CBF) and mean transit time (MTT) were obtained. Binary masks of WML, white matter (WM) and grey matter (GM) were automatically generated and co-registered to the perfusion maps. The WML mask was manually edited and modified to correct for errors in the automatic lesion detection. Perfusion parameters were derived both from WML and NAWM using the manually modified WML mask, and using the original non-modified WML mask (with and without GM exclusion mask). Differences in perfusion measures between WML and NAWM were analyzed. Results: CBF was significantly lower (p<0.001) and MTT significantly higher (p<0.001) in WML compared to NAWM. CBV did not show significant difference between WML and NAWM. The non-modified WML mask gave similar results as manually modified WML mask if the GM exclusion mask was used in the analysis. Conclusions: DSC PWI revealed lower CBF and higher MTT, consistent with reduced perfusion, in WML compared to NAWM in patients with early MS. Automatically generated binary masks are a promising tool in perfusion analysis of WML.
    European journal of radiology 09/2015; DOI:10.1016/j.ejrad.2015.09.007
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    ABSTRACT: Objective: To reevaluate idiopathic pulmonary fibrosis (IPF) cases which had surgical lung biopsy (SLB) for diagnosis of usual interstitial pneumonia (UIP), and examine the influence of computed tomography (CT) findings and clinical information based on diagnostic certainty. Methods: Ninety-five cases with multidisciplinary diagnoses of IPF were identified from eight institutions. All cases had SLB. Two expert chest radiologists and five expert pulmonologists used a 5-point scale to grade their level of certainty in the diagnosis of a radiological pattern of UIP or a clinical diagnosis of IPF (level 1 "definitely no" to level 5 "definitely yes"). Radiologists independently evaluated thin-section CT images and pulmonologists independently assessed clinical information. The two groups then discussed their diagnosis to obtain a final consensus, and listed alternative diagnoses. Changes in the level of certainty during the diagnostic process were investigated. Results: The level of certainty for IPF was judged as low (level 1 or 2) in 32 cases (34%) by radiologists and in three cases (3%) by pulmonologists; in the final consensus 39 cases (41%) were judged as low. Chronic hypersensitivity pneumonitis (CHP), interstitial pneumonia associated with collagen tissue diseases (CTD-IP), and idiopathic nonspecific interstitial pneumonia (idiopathic NSIP) were listed as alternative diagnoses. Conclusions: In this retrospective series, some cases that had UIP confirmed on SLB for IPF diagnosis were classified into a low-level certainty group by expert chest radiologists and pulmonologists. When a diagnosis of IPF is made, the possibility of CHP, CTD-IP, and idiopathic NSIP must be also considered.
    European journal of radiology 09/2015; DOI:10.1016/j.ejrad.2015.08.016
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    ABSTRACT: Purpose: Primary bone lymphoma (PBL) is a rare type of malignant lymphoma. Few data have been reported regarding the utility of F-18 FDG PET/CT in this disease. The aim of this study was to assess the role of F-18 FDG PET/CT in the diagnosis and therapeutic effect evaluation of PBL. Materials and methods: A total of 19 consecutive patients with PBL were enrolled. Whole-body PET/CT scan was performed for all patients. The diagnosis of PBL was established by histopathology and immunohistochemistry. Results: F-18 FDG PET/CT was positive in 94.7% (18/19) of patients. Uptake of FDG in lesions was intense with SUVmax of 15.14±11.82. Multiple involved lesions were found in 47.4% (9/19) patients, while 52.6% presented with a single involved lesion. Based on the lesions, PET detected 98.9% (87/88) lesions. Among them, 71.6% (63/88) lesions were found to be located in axial skeleton and 28.4% (25/88) in the extremity skeleton. FDG PET/CT also found the lesions infiltrate to the surrounding soft tissue in 84.2% (16/19) patients. On the syn-modality CT, the bone destruction was noted in 43.2% (38/88) of the lesions, of which 50.0% lesions presented as slight change in bone density and 50.0% as severe change. The diagnostic sensitivity of PET was much higher than that of CT (98.9% vs. 43.2%, P=0.000). PET/CT was performed for evaluation of treatment response in 13 patients. In 12 patients with complete response(CR), PET/CT found the 25 lesions were F-18 FDG fully resoluted after treatment, however, bone destruction was still presented in 72.0% (18/25) lesions. Conclusions: The present study suggests that F-18 FDG PET/CT was a sensitive imaging modality for diagnosis and treatment response evaluation of PBL.
    European journal of radiology 09/2015; DOI:10.1016/j.ejrad.2015.09.011
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    ABSTRACT: Purpose: The aim of the present study was to investigate the feasibility and image quality of excretory CT urography performed using low iodine-concentration contrast media and low tube voltage. Materials and methods: This prospective study enrolled 63 patients who undergoing CT urography. The subjects were randomized into two groups of an excretory phase CT urography protocol and received either 240mg I/mL of contrast media and 80kVp of tube voltage (low-concentration protocol, n=32) or 350mg I/mL and 120kVp (conventional protocol, n=31). Two readers qualitatively evaluated images for sharpness of the urinary tract, image noise, streak artifact and overall diagnostic acceptability. The mean attenuation, signal-to-noise ratio, contrast-to-noise ratio and figure of merit were measured in the urinary tract. The non-inferiority test assessed the diagnostic acceptability between the two protocol groups. Results: The low-concentration protocol showed a significantly lower effective radiation dose (3.44 vs. 5.70 mSv, P<.001). The diagnostic acceptability was significantly lower in the low-concentration protocol with iterative reconstruction algorithm than in the conventional protocol (4.06±0.45 vs. 4.50±0.37, P<.001), however, all subjects showed at least more than standard diagnostic acceptability and the difference resided in the predefined non-inferiority margin. The signal-to-noise ratio, contrast-to-noise ratio and figure of merit were significantly higher in the low-concentration protocol along the entire urinary tract (P<.001). Conclusion: CT urography using 240mg I/mL iodine contrast media, 80kVp tube voltage and an iterative reconstruction algorithm is beneficial to reduce radiation dose and iodine load, and its objective image quality and subjective diagnostic acceptability is not inferior to that of conventional CT urography.
    European journal of radiology 09/2015; DOI:10.1016/j.ejrad.2015.09.010
  • European journal of radiology 09/2015; DOI:10.1016/j.ejrad.2015.09.002
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    ABSTRACT: Purpose: To compare hybrid iterative reconstruction (HIR) with filtered back projection (FBP) in the volumetry of artificial pure ground-glass nodules (GGNs) with low-dose computed tomography (CT). Materials and methods: Artificial GGNs (10mm-diameter, 523.6mm(3), -660HU) in an anthropomorphic chest phantom were scanned by a 256-row multi-slice CT with three dose levels (10, 30, 100mAs). Each scan was repeated six times. Each set was reconstructed by FBP and HIR at 0.625-mm thickness. The volumes of artificial GGNs placed at the lung apex and middle lung field of the chest phantom were measured by two observers. Semi-automated measurements were performed by clicking the cursor in the center of GGNs, and manual measurements were performed by tracing GGNs on axial section. Modification of the trace was added on a sagittal or coronal section if necessary. Measurement errors were calculated for both the FBP and HIR at each dose level. We used the Wilcoxon signed rank test to identify any significant difference between the measurement errors of the FBP and HIR. Inter-observer, intra-observer, and inter-scan variabilities were evaluated by Bland Altman analysis with limits of agreements given by 95% confidence intervals. Results: There were significant differences in measurement errors only at the lung apex between FBP and HIR with 10mAs in both the semi-automated (observer 1, -37% vs. 7.2%; observer 2, -39% vs. 1.9%) and manual methods (observer 1, -29% vs. 7.5%; observer 2, -30% vs. 1.1%), respectively (P<0.05). HIR provided each variability equal to or less than one half of that of FBP at 10mAs in both methods. In the semi-automated method, the inter-observer and intra-observer variabilities obtained by HIR at 10mAs were -11% to 17% and -6.7% to 6.7%, whereas those for FBP at 10mAs were -29% to 30% and -38% to 20%, respectively. The inter-scan variability for FBP at 100mAs vs. HIR at 10mAs was -9.5% to 11%, and that for FBP at 100mAs vs. FBP at 10mAs was -73% to 32%. In the manual method, the inter-observer and intra-observer variabilities for HIR at 10mAs were -14% to 22% and -9.8% to 22%, and those for FBP at 10mAs were -45% to 36% and -31% to 28%, respectively. The inter-scan variability for FBP at 100mAs vs. HIR at 10mAs was -7.4% to 23%, and that for FBP at 100mAs vs. FBP at 10mAs was -52% to 26%. Conclusion: HIR is superior to FBP in the volumetry of artificial pure GGNs at lung apex with low-dose CT.
    European journal of radiology 09/2015; DOI:10.1016/j.ejrad.2015.08.018
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    ABSTRACT: Objective: The purpose of this study was to review the high-resolution computed tomography (CT) findings in patients with pulmonary complications after allogeneic hematopoietic stem cell transplantation (HSCT), and to evaluate the relationship between CT findings and clinical outcomes. Patients and methods: We collected the clinical data in 96 consecutive patients who underwent CT scan for pulmonary complications after allogeneic HSCT and analyzed the relationships among these clinical characteristics, CT findings and clinical responses. Radiologists who were blinded to clinical information evaluated the CT findings. Results: In multivariate analyses, the presence of chronic graft-versus-host disease (GVHD) and non-segmental multiple consolidations were significantly associated with a poor response to antimicrobial therapies, and the disease risk was significantly associated with a poor corticosteroid response. In addition, the existence of cavity formation and pleural effusion were significantly associated with a fatal prognosis. Twenty-five patients underwent bronchoscopic examination and 4 of them also underwent transbronchial lung biopsy (TBLB), but diagnostic information was not obtained in 15 patients. There was no significant association between specific CT findings and the diagnosis based on bronchoscopic examination. Conclusions: No specific CT finding was identified as a predictor for either an antimicrobial response or for a corticosteroid response in this study. The presence of cavity formation and pleural effusion may predict a poor prognosis.
    European journal of radiology 09/2015; DOI:10.1016/j.ejrad.2015.08.020
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    ABSTRACT: Objectives: To describe the imaging characteristics of superficial desmoid tumors using magnetic resonance imaging (MRI) and high-resolution sonography (HRUS). Methods: We retrospectively examined 18 patients (12 females and 6 males) with histologically proven superficial desmoids. Fourteen patients received MRI examinations, while 12 patients were examined with HRUS. The lesions were assessed with regard to location, muscular fascia involvement, and spread into the subcutaneous fatty tissue septa, adjacent muscle, and bone. In addition, size, shape, signal intensity/echogenicity relative to muscle, amount of collagen components, Doppler vascularity on HRUS and the degree of contrast enhancement in MRI were evaluated. Results: Altogether there were 20 subcutaneous lesions: six involved the chest wall and the breasts, five the hip, four each the shoulder and the flank, and one the abdominal wall. All but three lesions showed a stellar-type configuration with multiple irregular sun-burst-like extensions along the fascial planes and septa of the subcutaneous fat tissue. The extensions spread away from the main tumor focus, and in nine lesions, these extensions reached the cutis. The remaining three lesions had a spindle shape and also presented extensions along the fascial planes. Another imaging feature in all lesions was the presence of variable amounts of collagen components, with typical low signal on MRI and/or fibrillar hyperechoic appearance in HRUS. Conclusion: The distinctive imaging features of collagen components associated with sun-burst-like extensions in our sample of superficial desmoids are valuable diagnostic clues in the challenging non-invasive differential diagnosis of these tumors.
    European journal of radiology 09/2015; DOI:10.1016/j.ejrad.2015.08.012
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    ABSTRACT: Objective: The aim of this study was to examine the association between right atrium (RA) and right ventricle (RV) diameters on computed tomography (CT) pulmonary angiography in response to acute pulmonary embolism (APE), in addition to 30-day mortality and adverse outcomes in patients with APE. Methods: This retrospective study was accepted by the institutional ethics committee. From January 2013 to March 2014, 79 hospitalized adult patients with symptomatic APE were included. Inclusion criteria were a CT pulmonary angiography positive for pulmonary embolism, availability of patient records, and a follow-up of at least 30 days. A review of patient records and images was performed. The maximum diameters of the heart chambers were measured on a reconstructed four-chamber heart view, and the vascular obstruction index was calculated on CT pulmonary angiography. Results: There were statistically significant relationships in both the RA/RV diameter ratio and the RV/left ventricle (LV) diameter ratio between patients with and without adverse outcomes (p<0.001 and 0.002, respectively). Furthermore, there was a statistically significant difference in the RA/RV diameter ratio, but not in the RV/LV diameter ratio, between those with and without 30-day mortality (p=0.002 and 0.148, respectively). Conclusions: Measurement of the RA/RV diameter ratio may be an alternative and useful method for predicting 30-day mortality and adverse outcome in patients with APE.
    European journal of radiology 09/2015; DOI:10.1016/j.ejrad.2015.08.019
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    ABSTRACT: Purpose: To compare magnetic resonance spectroscopy (MRS) and diffusion weighted imaging (DWI) in the assessment of progression and regression of brain tumors in order to assess whether there is correlation between MRS and DWI in the monitoring of patients with primary tumors after therapy. Methods: Magnetic resonance imaging (MRI) has been performed in 80 patients, 48 affected by high grade gliomas (HGG) and 32 affected by low grade gliomas (LGG). The variation of apparent diffusion coefficient (ADC) value and metabolite ratios before and after treatment has been used to test DWI sequences and MRS as predictor to response to therapy. Comparison between post contrast-enhancement sequences, MRS and DWI has been done in terms of accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Moreover statistical correlation of ADC deviations with MRS metabolites variations before and after therapy have been studied. Results: In the case of HGG, MRS shows better sensitivity, specificity, PPV, NPV and accuracy compared to DWI, especially when considering the Choline/N-acetylaspartate (Cho/NAA) ratio. Regarding the LGG, the technique that better evaluates the response to treatment appears to be the DWI. A moderate correlation between ADC deviations and Cho, Lipide (Lip) and Lactate (Lac) has been found in LGG; while NAA revealed to be weakly correlated to ADC variation. Considering HGG, a weak correlation has been found between ADC deviations and MRS metabolites. Conclusion: Combination of DWI and MRS can help to characterize different changes related to treatment and to evaluate brain tumor response to treatment.
    European journal of radiology 09/2015; DOI:10.1016/j.ejrad.2015.09.005
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    ABSTRACT: Purpose: To investigate differences in joint space width (JSW) and meniscal extrusion (ME) between non-weight bearing (NWB) and weight bearing (WB) examinations of knee joints with medial compartment osteoarthritis (OA) using a cone-beam CT (CBCT) extremity imaging system. Materials and methods: In this IRB approved prospective study, informed consent was obtained for 17 patients symptomatic for OA (11 F,6M; 31-78 years, mean 56 years) and 18 asymptomatic controls (0 F,18M; 29-48 years, mean 38.5 years) enrolled for CBCT exams in NWB and WB positions. Three independent observers measured medial tibiofemoral JSW and ME. Measurements were compared between NWB and WB images using paired Wilcoxon signed-rank sum test. Results: OA subjects exhibited a statistically significant reduction in JSW between NWB and WB scans (average JSWNWB(OA)=2.1mm and JSWWB(OA)=1.5mm, p=0.016) and increase in ME (average MENWB(OA)=6.9mm and MEWB(OA)=8.2mm, p=0.018)). For non-OA subjects, the change in JSW and ME between NWB and WB exams was reduced (average JSWNWB(nonOA)=3.7mm and JSWWB(nonOA)=3.4mm; average MENWB(nonOA)=2.6mm and MEWB(nonOA)=2.7mm) and was not statistically significant. Inter-observer agreement was evaluated using Bland-Altman limits of agreement, with good agreement for all measurements (correlation coefficient 0.89-0.98). Conclusion: The ability to conduct NWB and WB exams in CBCT with a dose profile that is favorable in comparison to multidetector CT (MDCT) and with image quality sufficient for morphological analysis of joint space narrowing and meniscal extrusion could provide a valuable tool for OA diagnosis and treatment assessment.
    European journal of radiology 09/2015; DOI:10.1016/j.ejrad.2015.09.003
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    ABSTRACT: To evaluate dynamic contrast-enhanced computed tomography (CT) features of pancreatic neuroendocrine tumors (PNETs) containing areas of iso- or hypoattenuation and the relationship with pathological grading. Between June 2006 and March 2014, 61 PNETs in 58 consecutive patients (29 male, 29 female; median-age 55 years), which were surgically diagnosed, underwent preoperative dynamic contrast-enhanced CT. PNETs were classified based on contrast enhancement patterns in the pancreatic phase: iso/hypo-PNETs were defined as tumors containing areas of iso- or hypoattenuation except for cystic components, and hyper-PNETs were tumors showing hyperattenuation over the whole area. CT findings and contrast-enhancement patterns of the tumors were evaluated retrospectively by two radiologists and compared with the pathological grading. Iso/hypo-PNETs comprised 26 tumors, and hyper-PNETs comprised 35 tumors. Not only hyper-PNETs but also most iso/hypo-PNETs showed peak enhancement in the pancreatic phase and a washout from the portal venous phase to the delayed phase. Iso/hypo-PNETs showed larger tumor size than the hyper-PNETs (mean, 3.7cm vs. 1.6cm; P<0.001), and were significantly correlated with unclear tumor margins (n=4 vs. n=0; P=0.029), the existence of cystic components (n=10 vs. n=3; P=0.006), intratumoral blood vessels in the early arterial phase (n=13 vs. n=3; P<0.001), and a smooth rim enhancement in the delayed phase (n=12 vs. n=6; P=0.019). Iso/hypo-PNETs also showed significantly higher pathological grading (WHO 2010 classification; iso/hypo, G1=14, G2=11, G3=1; hyper, G1=34, G2=1; P<0.001). PNETs containing iso/hypo-areas showed a rapid enhancement pattern as well as hyper-PNETs, various radiological features and higher malignant potential. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    European journal of radiology 08/2015; DOI:10.1016/j.ejrad.2015.08.014
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    ABSTRACT: Introduction: Although NACD has proven to be an effective minimal invasive treatment for calcific tendinitis of the rotator cuff, little is known about the factors associated with treatment failure or the need for multiple procedures. Methods: Patients with symptomatic calcific tendinitis who were treated by NACD were evaluated in a retrospective cohort study. Demographic details, medical history, sonographic and radiographic findings were collected from patient files. Failure of NACD was defined as the persistence of symptoms after a follow-up of at least six months. NACD procedures performed within six months after a previous NACD procedure were considered repeated procedures. Multivariate logistic regression analysis was used to determine factors associated with treatment failure and multiple procedures. Results: 431 patients (277 female; mean age 51.4±9.9 years) were included. Smoking (adjusted odds ratio (AOR): 1.7, 95% CI 1.0-2.7, p=0.04) was significantly associated with failure of NACD. Patients with Gärtner and Heyer (GH) type I calcific deposits were more likely to need multiple NACD procedures (AOR: 3.4, 95% CI 1.6-7.5, p<0.01) compared to patients with type III calcific deposits. Partial thickness rotator cuff tears were of no influence on the outcome of NACD or the number of treatments necessary. Conclusion: Smoking almost doubled the chance of failure of NACD and the presence of GH type I calcific deposits significantly increased the chance of multiple procedures. Partial thickness rotator cuff tears did not seem to affect the outcome of NACD. Based on the findings in this study, the importance of quitting smoking should be emphasized prior to NACD and partial thickness rotator cuff tears should not be a reason to withhold patients NACD.
    European journal of radiology 08/2015; DOI:10.1016/j.ejrad.2015.07.030
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    ABSTRACT: To compare computed tomography (CT) findings in patients with pancreatic metastasis from renal cell carcinoma (pRCC) and patients with hypervascular pancreatic neuroendocrine tumour (pNET) with a focus on the relative percentage washout (RPW). We evaluated 16 patients with 37 pRCCs and 28 patients with 31 hypervascular pNETs using a protocol consisting of arterial and portal phase CT. Imaging findings were analyzed for comparison between the two groups. The RPW of each tumour using biphasic CT was obtained by two observers for evaluation of diagnostic performance. Interobserver agreement of each value and optimal cut-off level of RPW for discrimination between groups were evaluated. Tumour multiplicity showed significant difference in both groups. The mean RPW of the pRCC group (observer 1, 27.0%; observer 2, 29.4%) was significantly higher than that of the pNET group (observer 1, 0.5%; observer 2, 3.2%) (p<0.001 for each observer). Interobserver agreement for both attenuation values and RPWs was excellent. A RPW value of 19% was selected as the optimal cut-off for pRCC determination, and showed good performance (accuracy 83.8%, sensitivity 83.8%, and specificity 83.9%). With multiplicity, RPW of the tumour on CT could be helpful for differentiating pRCCs from hypervascular pNETs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    European journal of radiology 08/2015; DOI:10.1016/j.ejrad.2015.08.007
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    ABSTRACT: To evaluate any association between tumor apparent diffusion coefficient (ADC) values and axillary lymph node metastasis (ALNM) in early-stage invasive ductal carcinoma. Records of 270 invasive ductal carcinoma patients with stages T1 and T2 disease who underwent breast magnetic resonance imaging, including diffusion-weighted imaging with b values of 0 and 1000s/mm(2) were reviewed retrospectively. The tumor ADC values were analyzed for their utility in predicting ALNM using multivariate regression analysis and receiver operating characteristic (ROC) curve analysis. Of the 270 patients, 58 (21.5%) experienced ALNM. The mean tumor ADC values were significantly lower in patients with ALNM than in those without metastasis (0.880×10(-3) vs. 0.999×10(-3)mm(2)/s, P<0.001). A ROC curve demonstrated a tumor ADC value of 0.991×10(-3)mm(2)/s to be the optimal cut-off for predicting ALNM. In a multivariate analysis, lower tumor ADC (≤0.991×10(-3)mm(2)/s; adjusted odds ratio (OR)=5.861, P<0.001), large tumor size (>2cm; adjusted OR=3.156, P=0.002) and the presence of lymphovascular invasion (adjusted OR=4.125, P<0.001) were independent variables associated with ALNM. When tumor ADC value was added to known risk factors (i.e., tumor size and lymphovascular invasion), a significant improvement in the accuracy of risk prediction for axillary node metastasis was shown (c-statistic=0.758 vs. 0.816, P=0.026). In early-stage invasive ductal carcinoma, lower tumor ADC values are associated with the presence of ALNM. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    European journal of radiology 08/2015; DOI:10.1016/j.ejrad.2015.08.009
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    ABSTRACT: To compare the diagnostic competence of FAST-PET/MRI and PET/CT for whole-body staging of female patients suspect for a recurrence of a pelvic malignancy. 24 female patients with a suspected tumor recurrence underwent a PET/CT and subsequent PET/MRI examination. For PET/MRI readings a whole-body FAST-protocol was implemented. Two readers separately evaluated the PET/CT and FAST PET/MRI datasets regarding identification of all tumor lesions and qualitative assessment of visual lesion-to-background contrast (4-point ordinal scale). Tumor relapse was present in 21 of the 24 patients. Both, PET/CT and PET/MRI allowed for correct identification of tumor recurrence in 20 of 21 cases. Lesion-based sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy for the detection of malignant lesions were 82%, 91%, 97%, 58% and 84% for PET/CT and 85%, 87%, 96%, 63% and 86% for PET/MRI, lacking significant differences. Furthermore, no significant difference for lesion-to-background contrast of malignant and benign lesions was found. FAST-PET/MRI provides a comparably high diagnostic performance for restaging gynecological cancer patients compared to PET/CT with slightly prolonged scan duration, yet enabling a markedly reduced radiation exposure. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    European journal of radiology 08/2015; DOI:10.1016/j.ejrad.2015.08.010
  • European journal of radiology 08/2015; DOI:10.1016/j.ejrad.2015.08.011
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    ABSTRACT: Neurocognitive impairment is a common complication of cirrhosis and regarded as the important characteristic for early stage of hepatic encephalopathy (HE). This study aimed to investigate the changes in brain network centrality of functional connectivity among cirrhotic patients and uncover the mechanisms about early HE. Twenty-four cirrhotic patients without overt HE and 21 healthy controls were enrolled and underwent resting-state fMRI and Psychometric Hepatic Encephalopathy Score (PHES) tests. Whole-brain functional network was constructed by measuring the temporal correlations of every pairs of brain gray matter voxels; and then voxel-wise degree centrality (DC), an index reflecting importance of a node in functional integration, was calculated and compared between two groups. A seed-based resting-state functional connectivity (RSFC) analysis was further performed to investigate abnormal functional connectivity pattern of those regions with changed DC. Compared with controls, the cirrhotic patients had worse performances in all neurocognitive tests and lower PHES score. Meanwhile, patients showed decreased DC in bilateral medial prefrontal gyrus and anterior cingulate cortex, left middle frontal gyrus, and bilateral thalamus; while increased DC in right middle occipital gyrus and parahippocampal gyrus/inferior temporal gyrus. The seed-based RSFC analyses revealed that the relevant functional networks, such as default-mode and attention networks, visual network, and thalamo-cortical circuits, were disturbed in cirrhotic patients. The DC changes were correlated with PHES score in patient group. Our findings further confirm brain network disorganization in cirrhotic patients with neurocognitive impairments and may provide a new perspective for understanding HE-related mechanisms. Copyright © 2015. Published by Elsevier Ireland Ltd.
    European journal of radiology 08/2015; DOI:10.1016/j.ejrad.2015.08.005
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    ABSTRACT: To evaluate accuracy of contrast enhanced ultrasound (CEUS)-sentinel procedure followed by core biopsy (CB) and marking in patients with breast cancer. To compare the axillary metastatic tumour burden in patients with positive vs. negative CB results. Two radiologists in our tertiary care hospital performed axillary CEUS sentinel procedures on consecutive US node negative breast cancer patients. The first enhancing lymph node (LN) was core biopsied and marked with a breast coil. The results were compared to final histopathology. We analysed the diagnostic performance of CEUS CB and its ability to detect patients with higher axillary burden (>2 metastasis). During the study period between January 2013 and December 2014, altogether 54 patients (mean age 60.4 years) were included in the statistical analysis. The sensitivity for CEUS CB was 66.7%, specificity 100%, PPV 100%, NPV 93.8% and overall accuracy 94.4%. The method correctly recognised all the axillae with higher tumour burdens (sensitivity 100%, N=3) and 59.3% of coils marking the LNs were discovered. CEUS -guided axillary CB proved to be feasible and accurate procedure with moderate sensitivity and it clearly identified the higher axillary tumour burden. The coil marking of LNs as used cannot be recommended. In clinical routine, CEUS procedure might be recommended in selective patient populations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    European journal of radiology 08/2015; DOI:10.1016/j.ejrad.2015.08.006