L Martí-Bonmatí

Hospital Universitari i Politècnic la Fe, Valenza, Valencia, Spain

Are you L Martí-Bonmatí?

Claim your profile

Publications (266)439.32 Total impact

  • [show abstract] [hide abstract]
    ABSTRACT: The results of a randomized pilot study and qualitative evaluation of the clinical decision support system Curiam BT are reported. We evaluated the system's feasibility and potential value as a radiological information procedure complementary to magnetic resonance (MR) imaging to assist novice radiologists in diagnosing brain tumours using MR spectroscopy (1.5 and 3.0T). Fifty-five cases were analysed at three hospitals according to four non-exclusive diagnostic questions. Our results show that Curiam BT improved the diagnostic accuracy in all the four questions. Additionally, we discuss the findings of the users' feedback about the system, and the further work to optimize it for real environments and to conduct a large clinical trial.
    Computers in biology and medicine 02/2014; 45C:26-33. · 1.27 Impact Factor
  • Source
  • [show abstract] [hide abstract]
    ABSTRACT: Objectives The aim of this study is to evaluate the use of phase-contrast MR imaging to diagnose normal pressure hydrocephalus (NPH) and differentiate it from other neurological disorders with similar clinical symptoms. Methods The study included 108 subjects, of whom 61 were healthy controls and 47, patients; in the patient group, 19 had cerebrovascular disease (CVD) and 28 had NPH. All patients underwent a phase-contrast MRI study and several CSF flow and velocity parameters were measured at the aqueduct of Sylvius. Discriminant analyses were performed to evaluate the classification capacity of both individual parameters and the combination of different parameters. Results Maximum diastolic velocity, mean flow, and stroke volume showed statistically significant differences that could be used to distinguish between NPH and CVD patients (P<.001). Stroke volume and mean flow showed no false positive results and successful classification rates of 86% and 79%, respectively. No other parameters or combination produced better results. Conclusions Phase-contrast MR imaging is a useful tool for the early diagnosis of patients with NPH. CSF flow quantitative parameters, along with morphological features in a conventional MR study, enable us to differentiate between NPH and CVD patients.
    Neurología. 01/2014; 29(2):68–75.
  • [show abstract] [hide abstract]
    ABSTRACT: This paper discusses the potential of multivariate curve resolution models to extract physiological dynamics behaviors from dynamic contrast-enhanced magnetic resonance imaging prostate perfusion studies for cancer diagnosis. A relationship with biomarkers (“hidden” parameters for assessing the possible existence of a tumor) from pharmacokinetic models is also studied. Copyright © 2013 John Wiley & Sons, Ltd.
    Journal of Chemometrics 12/2013; · 1.94 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: We used an animal model to analyze the reproducibility and accuracy of certain biomarkers of bone image quality in comparison to a gold standard of computed microtomography (μCT). We used magnetic resonance (MR) imaging and μCT to study the metaphyses of 5 sheep tibiae. The MR images (3 Teslas) were acquired with a T1-weighted gradient echo sequence and an isotropic spatial resolution of 180μm. The μCT images were acquired using a scanner with a spatial resolution of 7.5μm isotropic voxels. In the preparation of the images, we applied equalization, interpolation, and thresholding algorithms. In the quantitative analysis, we calculated the percentage of bone volume (BV/TV), the trabecular thickness (Tb.Th), the trabecular separation (Tb.Sp), the trabecular index (Tb.N), the 2D fractal dimension (D(2D)), the 3D fractal dimension (D(3D)), and the elastic module in the three spatial directions (Ex, Ey and Ez). The morphometric and mechanical quantification of trabecular bone by MR was very reproducible, with percentages of variation below 9% for all the parameters. Its accuracy compared to the gold standard (μCT) was high, with errors less than 15% for BV/TV, D(2D), D(3D), and Eappx, Eappy and Eappz. Our experimental results in animals confirm that the parameters of BV/TV, D(2D), D(3D), and Eappx, Eappy and Eappz obtained by MR have excellent reproducibility and accuracy and can be used as imaging biomarkers for the quality of trabecular bone.
    Radiología 10/2013;
  • Pilar Ferrer, Luis Martí-Bonmatí, Enrique Mollá, Carlos Casillas
    [show abstract] [hide abstract]
    ABSTRACT: Background To evaluate the utility of myelography obtained with MR imaging (MR-myelography) as a complementary tool in patients studied with a conventional MR examination of the spine. Patients and methods 275 consecutive patients were included. All of them were studied with MR-myelography in 2 planes, coronal and sagittal, with a turbo spin-echo single-shot technique, as a complement to a conventional MR study of the spine; 130 were males and 145 women, with ages ranging from 20 to 71 years (mean, 45 years). The analyzed variables were age, sex, vertebral segment studied, alteration of the dural sac, intradural nerve roots, emergent roots, and presence of intradural lesions, meningeal cysts, and spinal stenosis. The added value of MR-myelography regarding conventional MR was categorized. Results MR-myelography obtained new information in 88 cases (32%), being considered irrelevant information in 42 cases and relevant in 46 cases (16.7% of all cases) (amputations of the emergent roots and alterations of the intradural roots). MR-myelography did not contribute to any type of additional information to the conventional MR study in 187 cases (68% of all studies). Conclusions MR-myelography is a rapid acquisition technique that supplements the conventional MR study of the spine, contributing with relevant new information in the analysis of the spine diseases 16.7% of cases.
    Medicina Clínica. 07/2013; 115(10):366–369.
  • [show abstract] [hide abstract]
    ABSTRACT: To evaluate the quantitative parameters obtained from dynamic MR T2*-weighted images as predictors of survival taking into consideration the biasing effects of other survival-related covariates. Thirty-nine patients (60 ± 14 years; survival 267 ± 191 days) with high-grade gliomas (8 grade III, 31 grade IV) were retrospectively included in the study. Additional data incorporated Karnofsky performance scale, tumour resection extension after surgery and type of treatment. Dynamic T2*-weighted MRI was acquired before treatment. Tumour curves were extracted for each voxel, and several quantitative parameters were obtained from the whole tumour volume and the 10 % maximum values. Additional image covariates included the presence of necrosis, single or multiple lesions, and tumour and oedema volumes. The relationship between quantitative parameters and survival was assessed using clusterisation techniques and the log-rank method. Cox regression analysis was used to evaluate each parameter's predictive value. Only the mean of the 10 % maximum values of the transfer coefficient showed an independent relationship with patient survival (log-rank chi-squared test <0.001, Cox regression P = 0.015), with higher values corresponding to lower survival rates. High maximum transfer coefficient values show an independent statistical relationship with low survival in high-grade glioma patients. This imaging biomarker can be used as a predictor of prognosis. • Histological examination is the standard procedure for predicting glioma biological behaviour. • Tumour biopsies may be biased by sample size and location. • Dynamic T2*-weighted MRI quantitative analysis characterises tumour vasculature at the voxel level. • High-transfer constant maximum values are independent predictors of low overall survival.
    European Radiology 07/2013; · 3.55 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: OBJECTIVES: The aim of this study is to evaluate the use of phase-contrast MR imaging to diagnose normal pressure hydrocephalus (NPH) and differentiate it from other neurological disorders with similar clinical symptoms. METHODS: The study included 108 subjects, of whom 61 were healthy controls and 47, patients; in the patient group, 19 had cerebrovascular disease (CVD) and 28 had NPH. All patients underwent a phase-contrast MRI study and several CSF flow and velocity parameters were measured at the aqueduct of Sylvius. Discriminant analyses were performed to evaluate the classification capacity of both individual parameters and the combination of different parameters. RESULTS: Maximum diastolic velocity, mean flow, and stroke volume showed statistically significant differences that could be used to distinguish between NPH and CVD patients (P<.001). Stroke volume and mean flow showed no false positive results and successful classification rates of 86% and 79%, respectively. No other parameters or combination produced better results. CONCLUSIONS: Phase-contrast MR imaging is a useful tool for the early diagnosis of patients with NPH. CSF flow quantitative parameters, along with morphological features in a conventional MR study, enable us to differentiate between NPH and CVD patients.
    Neurologia 05/2013;
  • [show abstract] [hide abstract]
    ABSTRACT: INTRODUCTION. Although aggressive behaviours are not always very highly prevalent in schizophrenia, their occurrence does represent a significant problem for patients and those around them. Although neuroimaging studies have made it possible to further our knowledge of the biology of these behaviours, there is still a notable degree of clinical heterogeneity in the study samples that makes it difficult to obtain conclusive results that can be compared with each other. AIM. To determine whether there are variations in the brain activity, as measured with functional magnetic resonance imaging, of a homogenous group of patients with schizophrenia and aggressive behaviour. PATIENTS AND METHODS. The sample consisted of 32 patients with refractory schizophrenia and auditory hallucinations selected for the study. The subjects were submitted to a functional magnetic resonance imaging examination using an auditory paradigm with emotional stimulation, while the degree of aggressiveness was measured by means of the Brief Psychiatric Rating Scale. RESULTS. Significant correlations were found between functional activation and the degree of aggressiveness, which show focal hyperactivations in patients with a greater association to violent behaviours. The areas identified were located in the left hippocampus (p < 0.003, corrected) and in the right medial frontal gyrus (p < 0.004, corrected). CONCLUSIONS. This study determines the association between the degree of aggressiveness and certain regions in the brain that are responsible for cognitive and emotional processing in a phenotypically very homogenous group of patients with chronic auditory hallucinations and schizophrenia. This alteration of the neuronal circuits can favour loss in the processes involved in empathy and sensitivity, thus favouring the appearance of aggressive behaviours.
    Revista de neurologia 02/2013; 56(4):193-9. · 1.18 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: Imaging biomarkers describe objective characteristics that are related to normal biological processes, diseases, or the response to treatment. They enable radiologists to incorporate into their reports data about structure, function, and tissue components. With the aim of taking maximum advantage of the quantification of medical images, we present a procedure to integrate imaging biomarkers into radiological reports, bringing the new paradigm of personal medicine closer to radiological workflow. In this manner, the results of quantification can complement traditional radiological diagnosis, improving accuracy and the evaluation of the efficacy of treatments. A more personalized, standardized, structured radiological report should include quantitative analyses to complement conventional qualitative reporting in selected cases.
    Radiología 01/2013;
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: Image-guided diagnostic and therapeutic procedures are related to, or performed under, some kind of imaging. Such imaging may be direct inspection (as in open surgery) or indirect inspection as in endoscopy or laparoscopy. Common to all these techniques is the transformation of optical and visible information to a monitor or the eye of the operator. Image-guided therapy (IGT) differs by using processed imaging data acquired before, during and after a wide range of different imaging techniques. This means that the planning, performing and monitoring, as well as the control of the therapeutic procedure, are based and dependent on the "virtual reality" provided by imaging investigations. Since most of such imaging involves radiology in the broadest sense, there is a need to characterise IGT in more detail. In this paper, the technical, medico-legal and medico-political issues will be discussed. The focus will be put on state-of-the-art imaging, technical developments, methodological and legal requisites concerning radiation protection and licensing, speciality-specific limitations and crossing specialty borders, definition of technical and quality standards, and finally to the issue of awareness of IGT within the medical and public community. The specialty-specific knowledge should confer radiologists with a significant role in the overall responsibility for the imaging-related processes in various non-radiological specialties. These processes may encompass purchase, servicing, quality management, radiation protection and documentation, also taking responsibility for the definition and compliance with the legal requirements regarding all radiological imaging performed by non-radiologists.
    Insights into imaging. 01/2013;
  • Source
    01/2013: pages 51-66; , ISBN: ISBN 978-953-51-0923-5
  • [show abstract] [hide abstract]
    ABSTRACT: Objective To evaluate the changes in the size of focal nodular hyperplasia (FNH) during long-term magnetic resonance imaging (MRI) follow-up. Material and methods We reviewed 44 FNHs in 30 patients studied with MRI with at least two MRI studies at least 12 months apart. We measured the largest diameter of the lesion (in mm) in contrast-enhanced axial images and calculated the percentage of variation as the difference between the maximum diameter in the follow-up and the maximum diameter in the initial study. We defined significant variation in size as variation greater than 20%. We also analyzed predisposing hormonal factors. Results The mean interval between the two imaging studies was 35 ± 2 months (range: 12-94). Most lesions (80%) remained stable during follow-up. Only 9 of the 44 lesions (20%) showed a significant variation in diameter: 7 (16%) decreased in size and 2 (4%) increased, with variations that reached the double of the initial size. The change in size was not related to pregnancy, menopause, or the use of birth control pills or corticoids. Conclusion Changes in the size of FNHs during follow-up are relatively common and should not lead to a change in the diagnosis. These variations in size seem to be independent of hormonal factors that are considered to predispose.
    Radiología. 01/2013; 55(6):499–504.
  • [show abstract] [hide abstract]
    ABSTRACT: Imaging biomarkers describe objective characteristics that are related to normal biological processes, diseases, or the response to treatment. They enable radiologists to incorporate into their reports data about structure, function, and tissue components. With the aim of taking maximum advantage of the quantification of medical images, we present a procedure to integrate imaging biomarkers into radiological reports, bringing the new paradigm of personal medicine closer to radiological workflow. In this manner, the results of quantification can complement traditional radiological diagnosis, improving accuracy and the evaluation of the efficacy of treatments. A more personalized, standardized, structured radiological report should include quantitative analyses to complement conventional qualitative reporting in selected cases.
    Radiología. 01/2013; 55(3):188–194.
  • [show abstract] [hide abstract]
    ABSTRACT: Objective We used an animal model to analyze the reproducibility and accuracy of certain biomarkers of bone image quality in comparison to a gold standard of computed microtomography (μCT). Material and methods We used magnetic resonance (MR) imaging and μCT to study the metaphyses of 5 sheep tibiae. The MR images (3 Teslas) were acquired with a T1-weighted gradient echo sequence and an isotropic spatial resolution of 180 μm. The μCT images were acquired using a scanner with a spatial resolution of 7.5 μm isotropic voxels. In the preparation of the images, we applied equalization, interpolation, and thresholding algorithms. In the quantitative analysis, we calculated the percentage of bone volume (BV/TV), the trabecular thickness (Tb.Th), the trabecular separation (Tb.Sp), the trabecular index (Tb.N), the 2 D fractal dimension (D2D), the 3 D fractal dimension (D3D), and the elastic module in the three spatial directions (Ex, Ey and Ez). Results The morphometric and mechanical quantification of trabecular bone by MR was very reproducible, with percentages of variation below 9% for all the parameters. Its accuracy compared to the gold standard (μCT) was high, with errors less than 15% for BV/TV, D2D, D3D, and Eappx, Eappy and Eappz. Conclusions Our experimental results in animals confirm that the parameters of BV/TV, D2D, D3D, and Eappx, Eappy and Eappz obtained by MR have excellent reproducibility and accuracy and can be used as imaging biomarkers for the quality of trabecular bone.
    Radiología. 01/2013;
  • [show abstract] [hide abstract]
    ABSTRACT: Hepatocellular carcinoma (HCC) management takes into account clinical and radiological findings, such as tumor stage, hepatic functional status and clinical symptoms. It is necessary to evaluate the number, size and location of the lesions. However, lesion aggressiveness is not considered in this therapeutic workflow, although the biology and the growth rate of the lesions have an important impact on survival. The aim of this work was to establish if the quantitative pharmacokinetic assessment of dynamic contrast-enhanced magnetic resonance images of HCC can separate lesions with different microvascular properties and biological evolution. Forty five patients with HCC and dynamic contrast-enhanced MRI examinations were included and several pharmacokinetic parameters were calculated. Statistical clusterization techniques were applied and two clearly distinct groups were obtained by using vascular properties and average lesion size. These groups differed by the proportion of deceased patients, although no statistically significant differences were found between the average survival times of both groups.
    Expert review of gastroenterology & hepatology 12/2012; 6(6):711-6.
  • [show abstract] [hide abstract]
    ABSTRACT: OBJECTIVES: To evaluate the sensation of pleasantness perceived by patients attended in the radiology department in response to decorative elements hung on the walls in the waiting rooms and in the hallways of the imaging area. MATERIAL AND METHODS: The material resources comprised works of art in the form of "magic windows" representing scenes from nature installed on the ceilings and walls of the waiting area and hallways of the imaging area. Patients were given a brief questionnaire with general data and questions (sadness-cheerfulness, coldness-warmth, darkness-light, and pessimism-optimism) about their perception of the decorative elements. RESULTS: Of the 150 questionnaires collected, 142 were filled out correctly. The overall health of these patients was good in 84 (56%), not bad in 58 (39%), and poor in 8 (5%). The idea seemed very good to 70 patients (47%), good to 58 (39%), not bad to 8 (5%), indifferent to 11 (7%), bad to 1 (1%), and very bad to 2 (1%). As far a patients' mobility, 119 patients (79%) walked into the department, 18 (12%) were wheeled in on beds, and 13 (9%) needed wheelchairs. CONCLUSIONS: We found a high level of satisfaction with the decorative elements.
    Radiología 11/2012;
  • Source
    © 2012 EdikaMed, S.L. edited by Luis Marti-Bonmati, 10/2012; , ISBN: 978-84-7877--
  • [show abstract] [hide abstract]
    ABSTRACT: PURPOSE: To report the success of groin nodal lymphography in the diagnosis and treatment of genital lymphedema. METHODS AND MATERIALS: We present one female (8 years old [patient no. 1]) and two male (69 and [patient no. 2] 31 years old [patient no. 3], respectively) patients with genital lymphedema in whom conservative treatment failed. The girl also had lymphorrhagia. Genital lymphedema was caused by radical cystectomy (patient no. 2), lymphatic hyperplasia (patient no. 1), and idiopathic lymphangitis (patient no. 3). All of them underwent ultrasound-guided bilateral groin lymph node puncture. Afterward, 4-8 ml Lipiodol Ultra-Fluide (Guerbet) were injected at a rate of 0.2 ml/s. Lipiodol progression was assessed by fluoroscopy. Computed tomography scan of the abdomen and pelvis was performed immediately after and again at 24 h after the procedure to confirm the leak. The follow-up period was 15, 13, and 9 months, respectively. Technical success was considered as bilateral pelvic and abdominal filling of lymphatic vessels. Therapeutic success was considered as improvement or disappearance of genital lymphedema and/or lymphorrhagia. RESULTS: Lipiodol leak to the scrotum was observed in patients no. 2 and 3. Lymphaticopelvic fistula and genital lymphatic hyperplasia were seen in patient no. 1. Genital lymphedema diminished within 1 week and almost disappeared in two cases (patients no. 1 and 3) or significantly improved (patient no. 2). lymphorrhagia also resolved in patient no. 1. No recurrence or worsening was detected during follow-up. CONCLUSION: Therapeutic lymphangiography by lymph node injection seems to be effective to treat genital lymphedema. Lymph node puncture lymphangiography is feasible and less cumbersome than pedal lymphangiography.
    CardioVascular and Interventional Radiology 08/2012; · 2.09 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: OBJECTIVE: To evaluate the changes in the size of focal nodular hyperplasia (FNH) during long-term magnetic resonance imaging (MRI) follow-up. MATERIAL AND METHODS: We reviewed 44 FNHs in 30 patients studied with MRI with at least two MRI studies at least 12 months apart. We measured the largest diameter of the lesion (inmm) in contrast-enhanced axial images and calculated the percentage of variation as the difference between the maximum diameter in the follow-up and the maximum diameter in the initial study. We defined significant variation in size as variation greater than 20%. We also analyzed predisposing hormonal factors. RESULTS: The mean interval between the two imaging studies was 35±2 months (range: 12-94). Most lesions (80%) remained stable during follow-up. Only 9 of the 44 lesions (20%) showed a significant variation in diameter: 7 (16%) decreased in size and 2 (4%) increased, with variations that reached the double of the initial size. The change in size was not related to pregnancy, menopause, or the use of birth control pills or corticoids. CONCLUSION: Changes in the size of FNHs during follow-up are relatively common and should not lead to a change in the diagnosis. These variations in size seem to be independent of hormonal factors that are considered to predispose.
    Radiología 06/2012;

Publication Stats

2k Citations
439.32 Total Impact Points

Institutions

  • 1988–2013
    • Hospital Universitari i Politècnic la Fe
      • Department of Radiology
      Valenza, Valencia, Spain
  • 1994–2012
    • University of Valencia
      • • Departamento de Psicobiología
      • • Departamento de Química Física
      Valenza, Valencia, Spain
  • 2011
    • Universidad Internacional Valenciana
      Valenza, Valencia, Spain
    • International Society for Magnetic Resonance in Medicine
      California, United States
  • 1992–2010
    • Hospital Universitario Doctor Peset
      • • Servicio de Radiodiagnóstico
      • • Department of Radiology
      Valencia, Valencia, Spain
  • 2006–2009
    • Polytechnical University of Valencia
      • • Department of Electronic Engineering
      • • Institute for the Implementation of Advanced Information and Communications Technologies (ITACA)
      Valencia, Valencia, Spain
  • 2008
    • Hospital Clínico Universitario de Valencia
      Valenza, Valencia, Spain
    • Grupo Hospitalario Quirón
      Pozuelo, Madrid, Spain
  • 1997
    • Hospital la Magdalena
      Castellón, Valencia, Spain