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    ABSTRACT: To evaluate the potential usefulness of high b-value body diffusion-weighted images (DWIs) as a screening tool in the depiction of abdominal malignant tumors. We selected 110 abdominal magnetic resonance examinations (1.5 T; 60 men; age range, 25-90 years) with and without malignant tumors (n = 37 and n = 73, respectively). Axial DWIs were obtained by single-shot spin-echo (SE) type echo planar imaging (EPI) sequence with inversion pulse (repetition time, 6,800 msec; echo time, 100 msec; T1, 150 msec; b value, 1,000 sec/mm(2)) without breath-holding. Two radiologists independently interpreted the DWIs, T2-weighted images (T2-WI), all three types of images including DWIs, T2-WIs, and fusion images at the same time (DWIs + T2-WIs + fusion) with 7-14 days' interval, and the diagnostic confidence for each patient was scored. The area under the curve (AUC) of the composite receiver operating characteristic (ROC) curve of DWIs + T2-WIs + fusion (0.904) was significantly higher than those of DWIs (0.720; P < .001) and T2-WIs (0.822; P < .05). Both sensitivity and specificity were higher in DWIs + T2-WIs + fusion (89.5% and 81.9%, respectively) compared with those of DWIs (72.4% and 59.0%; P < .01 and P < .001, respectively). Abdominal high b-value DWIs have a high sensitivity and specificity for malignant tumors when T2-WIs are referred and image fusion technique is employed, suggesting that it may potentially be a new screening tool.
    No preview · Article · Jun 2007 · Academic Radiology
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    ABSTRACT: Current patterns of imaging utilization lead to frequent serendipitous discovery of renal lesions. Today, the majority of solid renal masses that are ultimately proved to be renal cell carcinomas were incidental findings on imaging studies performed for non-urinary tract symptoms. While earlier discovery has led to treatment of smaller and earlier-stage malignancies, the percentage of benign lesions discovered has also increased. A strategy for characterization of solid masses in adults based on the lesion's growth pattern, the "ball" versus the "bean," is presented. Common and uncommon renal masses, in concert with clinical and other imaging clues, are reviewed within the context of a renal ball or bean.
    No preview · Article · Jun 2008 · Radiology
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    ABSTRACT: To investigate the activities, motivations, and attitudes of radiologists regarding specific computed tomographic (CT) screening examinations by using a survey. All study activities were approved by the institutional review board. A self-administered, mailed survey was used to collect data on the practices and attitudes of U.S. radiologists regarding three CT screening tests--coronary artery calcium scoring (CACS), lung cancer screening CT, and whole-body screening CT. The survey was sent to 1000 diagnostic radiologists who were randomly sampled from the American Medical Association Physician Masterfile. A total of 398 (41.4%) of 961 eligible radiologists completed the survey. Among respondents, 33.6% reported reading CT screening studies, the most common being CACS (26.7%), followed by lung screening (19.2%) and whole-body screening (9.5%). Among respondents, 34.1% supported CACS and 29.9% supported lung CT screening for particular patients, while 1.9% supported whole-body CT screening. The most common reasons reported for reading CT screening studies were responses to requests from physicians (83.3%) or patients (75.0%), while fewer (40.8%) cited patient benefit from screening as a reason. A substantial proportion of a nationally representative sample of radiologists in the United States reads CT screening studies of the heart, lungs, and whole body and holds favorable attitudes toward CACS and lung CT screening. These attitudes may allow for the premature diffusion of new screening tests into practice before higher-level evidence demonstrates their benefits for population mortality.
    Full-text · Article · Aug 2008 · Radiology
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