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The British Journal of Radiology Dec 2019Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis which can have a broad range of clinical and radiological presentations. Typically, ECD affects... (Review)
Review
Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis which can have a broad range of clinical and radiological presentations. Typically, ECD affects multiple organ systems, with skeletal involvement present in almost all ECD patients and cardiothoracic manifestations in more than half. Cardiac and thoracic involvement contributes significantly to morbidity and mortality in affected patients and may have prognostic implications. The diagnosis of ECD can be challenging due to its rarity and similarity to other systemic disease processes. Although the diagnosis can be suggested on imaging, histopathology and immunohistochemistry are required for confirmation. We describe the multimodal imaging features of mediastinal, cardiac, pleural and lung parenchymal ECD. This review identifies the most common radiological manifestations of cardiac and thoracic ECD on contrast-enhanced CT, fluorine-fludeoxyglucose positron emission tomography/CT and cardiac MRI, and highlights the role of these cross-sectional techniques in disease diagnosis.
Topics: Contrast Media; Erdheim-Chester Disease; Fluorodeoxyglucose F18; Heart Diseases; Humans; Lung Diseases; Magnetic Resonance Imaging; Mediastinal Diseases; Multimodal Imaging; Pleural Diseases; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Tomography, X-Ray Computed
PubMed: 31386554
DOI: 10.1259/bjr.20190473 -
The British Journal of Ophthalmology Apr 2022To describe clinical and multimodal imaging features in a cohort of choroidal macrovessels. (Review)
Review
BACKGROUND/AIMS
To describe clinical and multimodal imaging features in a cohort of choroidal macrovessels.
METHODS
Demographics and multimodal imaging features of 16 eyes of 13 patients with choroidal macrovessels were reviewed. The multimodal imaging included colour fundus photography, fundus autofluorescence (FAF), spectral domain enhanced depth imaging optical coherence tomography (OCT), en face OCT, OCT-angiography (OCT-A), B-scan ultrasonography (US), fluorescein angiography (FFA) and indocyanine green angiography (ICGA).
RESULTS
Three patients had bilateral involvement. On colour fundus photography, three patterns were evident (a clearly visible orange-red vessel; a track of pigmentary changes; spots of mild pigmentary changes). Vessel orientation was horizontal (11 eyes), oblique (4 eyes) or vertical (1 eye). In 2 eyes, the vessel was extra-macular. OCT in all cases showed a hyporeflective choroidal area with posterior shadowing and elevation of the overlying retina. Subretinal fluid was present in 4 eyes. FAF (12 eyes) was normal (7 eyes) or showed a hypofluorescent/hyperfluorescent track (4 eyes) or linear hyperautofluorescence (1 eye). En-face OCT (2 eyes) revealed the course of the macrovessel at the level of choroid and choriocapillaris. On OCT-A (2 eyes) the vessel had a reflectivity similar to surrounding vessels but larger diameter. B-scan US (8 eyes) showed a nodular hypoechogenic lesion. FFA (5 eyes) showed early focal hyperfluorescence (4 eyes) not increasing in later phases, or was normal (1 eye). ICGA (6 eyes) showed early hyperfluorescence of the vessel.
CONCLUSIONS
Choroidal macrovessels can mimic other entities, leading to underdiagnosis. Appreciating relevant features on different imaging modalities will aid a correct diagnosis.
Topics: Choroid; Diagnostic Techniques, Ophthalmological; Fluorescein Angiography; Humans; Multimodal Imaging; Retrospective Studies; Tomography, Optical Coherence
PubMed: 33397653
DOI: 10.1136/bjophthalmol-2020-318095 -
Circulation. Cardiovascular Imaging Jun 2021Cardiac amyloidosis (CA) is a disease characterized by the deposition of misfolded protein deposits in the myocardial interstitium. Although advanced CA confers... (Review)
Review
Cardiac amyloidosis (CA) is a disease characterized by the deposition of misfolded protein deposits in the myocardial interstitium. Although advanced CA confers significant morbidity and mortality, the magnitude of deposition and ensuing clinical manifestations vary greatly. Thus, an improved understanding of disease pathogenesis at both cellular and functional levels would afford critical insights that may improve outcomes. This review will summarize contemporary therapies for the 2 major types of CA, transthyretin and light chain amyloidosis, and outline the capacity of imaging modalities to both diagnose CA, inform prognosis, and follow response to available therapies. We explore the current landscape of echocardiography, cardiac magnetic resonance, and bone scintigraphy in the assessment of functional and cellular parameters of dysfunction in CA throughout disease pathogenesis. Finally, we examine the impact of concurrent advances in both therapeutics and imaging on future research questions that improve our understanding of underlying disease mechanisms. Multimodal imaging in CA affords an indispensable tool to offer individualized treatment plans and improve outcomes in patients with CA.
Topics: Biopsy; Cardiomyopathies; Disease Management; Disease Progression; Echocardiography; Humans; Multimodal Imaging; Myocardium; Prognosis
PubMed: 34129344
DOI: 10.1161/CIRCIMAGING.121.009025 -
RoFo : Fortschritte Auf Dem Gebiete Der... May 2024
Topics: Humans; Neoplasm Staging; Fluorodeoxyglucose F18; Magnetic Resonance Imaging; Positron-Emission Tomography; Multimodal Imaging; Radiopharmaceuticals; Lymphoma; Sensitivity and Specificity; Contrast Media; Child
PubMed: 38663378
DOI: 10.1055/a-2266-3765 -
AJNR. American Journal of Neuroradiology Jul 2022Modern pediatric imaging seeks to provide not only exceptional anatomic detail but also physiologic and metabolic information of the pathology in question with as little... (Review)
Review
Modern pediatric imaging seeks to provide not only exceptional anatomic detail but also physiologic and metabolic information of the pathology in question with as little radiation penalty as possible. Hybrid PET/MR imaging combines exquisite soft-tissue information obtained by MR imaging with functional information provided by PET, including metabolic markers, receptor binding, perfusion, and neurotransmitter release data. In pediatric neuro-oncology, PET/MR imaging is, in many ways, ideal for follow-up compared with PET/CT, given the superiority of MR imaging in neuroimaging compared with CT and the lower radiation dose, which is relevant in serial imaging and long-term follow-up of pediatric patients. In addition, although MR imaging is the main imaging technique for the evaluation of spinal pathology, PET/MR imaging may provide useful information in several clinical scenarios, including tumor staging and follow-up, treatment response assessment of spinal malignancies, and vertebral osteomyelitis. This review article covers neuropediatric applications of PET/MR imaging in addition to considerations regarding radiopharmaceuticals, imaging protocols, and current challenges to clinical implementation.
Topics: Child; Fluorodeoxyglucose F18; Humans; Magnetic Resonance Imaging; Multimodal Imaging; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Radiopharmaceuticals
PubMed: 35512826
DOI: 10.3174/ajnr.A7464 -
Retina (Philadelphia, Pa.) Sep 2023To describe the clinical and multimodal imaging features of stellate multiform amelanotic choroidopathy (SMACH; also known as serous maculopathy due to aspecific... (Observational Study)
Observational Study
PURPOSE
To describe the clinical and multimodal imaging features of stellate multiform amelanotic choroidopathy (SMACH; also known as serous maculopathy due to aspecific choroidopathy).
METHODS
Retrospective observational case series of eyes presenting with SMACH. Multimodal imaging including fundus photography, optical coherence tomography (OCT), OCT angiography (OCTA), and indocyanine green angiography (ICGA) was analyzed.
RESULTS
Eighteen eyes from 18 patients (mean age: 28 ± 19 years) were included. The mean follow-up duration was 9 years. Ophthalmoscopy showed a yellowish orange, dendriform choroidal lesion. At presentation, subretinal fluid (SRF) was seen in 10 of 18 cases (56%). Eight patients (44%) showed no evidence of SRF during a mean follow-up of 6 years. Cross-sectional OCT showed hyperreflective fibrous-like changes within the inner choroid with choriocapillaris flow preservation on OCTA. En face OCT showed a hyperreflective choroidal lesion with finger-like projections oriented in a stellate configuration. On ICGA, SMACH showed early and late hypofluorescence. None of the cases showed lesion growth.
CONCLUSION
SMACH seems to be a unilateral choroidopathy characterized by distinctive multimodal imaging features. As SRF was absent in some cases, while a dendriform pattern was a consistent finding in all eyes, the authors propose renaming this entity "stellate multiform amelanotic choroidopathy," a name that retains its previous abbreviation "SMACH."
Topics: Adolescent; Adult; Child; Humans; Middle Aged; Young Adult; Choroid; Cross-Sectional Studies; Fluorescein Angiography; Indocyanine Green; Multimodal Imaging; Retinal Diseases; Retrospective Studies; Tomography, Optical Coherence
PubMed: 37127025
DOI: 10.1097/IAE.0000000000003826 -
PET Clinics Oct 2020Cardiac PET/MR imaging is an integrated imaging approach that requires less radiation than PET/computed tomography and combines the high spatial resolution and... (Review)
Review
Cardiac PET/MR imaging is an integrated imaging approach that requires less radiation than PET/computed tomography and combines the high spatial resolution and morphologic data from MR imaging with the physiologic information from PET. This hybrid approach has the potential to improve the diagnostic and prognostic evaluation of several cardiovascular conditions, such as ischemic heart disease, infiltrative diseases such as sarcoidosis, acute and chronic myocarditis, and cardiac masses. Herein, the authors discuss the strengths of PET and MR imaging in several cardiovascular conditions; the challenges and potential; and the current data on the application of this powerful hybrid imaging modality.
Topics: Cardiovascular Diseases; Cardiovascular System; Humans; Magnetic Resonance Imaging; Multimodal Imaging; Positron-Emission Tomography
PubMed: 32888548
DOI: 10.1016/j.cpet.2020.06.007 -
Journal of the American College of... Nov 2023Derangements in the innate and adaptive immune responses observed in systemic inflammatory syndromes contributes to unique elevated atherosclerotic risk and incident... (Review)
Review
Derangements in the innate and adaptive immune responses observed in systemic inflammatory syndromes contributes to unique elevated atherosclerotic risk and incident cardiovascular disease. Novel multimodality imaging techniques may improve diagnostic precision for the screening and monitoring of disease activity. The integrated application of these technologies lead to earlier diagnosis and noninvasive monitoring of cardiac involvement in systemic inflammatory diseases that will aid in preclinical studies, enhance patient selection, and provide surrogate endpoints in clinical trials, thereby improving clinical outcomes. We review the common cardiovascular manifestations of immune-mediated systemic inflammatory diseases and address the clinical and investigational role of advanced multimodality cardiac imaging.
Topics: Humans; Heart; Cardiovascular Diseases; Cardiac Imaging Techniques; Multimodal Imaging
PubMed: 37993205
DOI: 10.1016/j.jacc.2023.09.819 -
Circulation Oct 2023Advances in cancer therapeutics have led to dramatic improvements in survival, now inclusive of nearly 20 million patients and rising. However, cardiovascular toxicities... (Review)
Review
Advances in cancer therapeutics have led to dramatic improvements in survival, now inclusive of nearly 20 million patients and rising. However, cardiovascular toxicities associated with specific cancer therapeutics adversely affect the outcomes of patients with cancer. Advances in cardiovascular imaging have solidified the critical role for robust methods for detecting, monitoring, and prognosticating cardiac risk among patients with cancer. However, decentralized evaluations have led to a lack of consensus on the optimal uses of imaging in contemporary cancer treatment (eg, immunotherapy, targeted, or biological therapy) settings. Similarly, available isolated preclinical and clinical studies have provided incomplete insights into the effectiveness of multiple modalities for cardiovascular imaging in cancer care. The aims of this scientific statement are to define the current state of evidence for cardiovascular imaging in the cancer treatment and survivorship settings and to propose novel methodological approaches to inform the optimal application of cardiovascular imaging in future clinical trials and registries. We also propose an evidence-based integrated approach to the use of cardiovascular imaging in routine clinical settings. This scientific statement summarizes and clarifies available evidence while providing guidance on the optimal uses of multimodality cardiovascular imaging in the era of emerging anticancer therapies.
Topics: United States; Humans; American Heart Association; Neoplasms; Medical Oncology; Multimodal Imaging; Cardiovascular Diseases
PubMed: 37732422
DOI: 10.1161/CIR.0000000000001174 -
Radiologic Clinics of North America Sep 2020Blunt trauma accounts for more than 95% of traumatic renal injury and results from shear forces from rapid acceleration or deceleration and/or collision against the... (Review)
Review
Blunt trauma accounts for more than 95% of traumatic renal injury and results from shear forces from rapid acceleration or deceleration and/or collision against the spine or ribs. The use of multiphasic contrast-enhanced computed tomography (CT) has proven pivotal in the evaluation and management of traumatic kidney injury, and CT imaging features provide the basis for nonsurgical staging. This article describes the epidemiology and mechanisms of blunt and penetrating traumatic renal injury and reviews the range of findings from various imaging modalities, with a particular emphasis on contrast-enhanced CT.
Topics: Humans; Kidney; Magnetic Resonance Imaging; Multimodal Imaging; Tomography, X-Ray Computed; Ultrasonography; Wounds, Nonpenetrating; Wounds, Penetrating
PubMed: 32792127
DOI: 10.1016/j.rcl.2020.05.005