Endorsement of the “firewater myth” affects the use of protective behavioral strategies among American Indian and Alaska native students

Publication date: Available online 22 January 2019

Source: Addictive Behaviors

Author(s): Vivian M. Gonzalez, Adrian J. Bravo, Maria C. Crouch, Protective Strategies Study Team

Abstract

Belief in an American Indian/Alaska Native (AI/AN) specific biological vulnerability (BV) to alcohol problems (aka the "firewater myth") has been found to be associated with worse alcohol outcomes among AI/AN college students who drink, despite also being associated with greater attempts to reduce drinking. In the current study, we examined the associations of belief in a BV and belief that AI/AN people have more alcohol problems with the use of alcohol protective behavioral strategies (PBS) among AI/AN college students. PBS examined, as measured by the Protective Behavioral Strategies Scale-20, included manner of drinking, limiting/stopping drinking, and serious harm reduction strategies. Participants were college students who identified being AI/AN (n = 137) and had drank in the past month, and were selected from a larger multi-site study on PBS. Mediation models revealed that greater belief in a BV and belief that AI/AN people have more alcohol problems were both negatively associated with manner of drinking, which in turn was associated with greater past month alcohol use and alcohol consequences. These beliefs were not significantly associated with other PBS. Consistent with prior research with other student populations, both manner of drinking and limiting/stopping drinking were associated with less alcohol use and all three domains of PBS were directly associated with fewer alcohol consequences. The results suggest that these beliefs regarding AI/AN people and alcohol negatively affect the use of strategies aimed at avoiding drinking behavior that can lead to rapid drinking and a higher blood alcohol content, contributing to alcohol consequences.

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Self-initiated gradual smoking reduction among community correction smokers

Publication date: Available online 22 January 2019

Source: Addictive Behaviors

Author(s): Mickeah J. Hugley, Caitlin Wolford-Clevenger, Michelle L. Sisson, Angela T. Nguyen, Karen L. Cropsey

Abstract

Introduction

Smoking remains the leading cause of preventable death in the United States. Many smoking cessation guidelines advise smokers to quit precipitately; however, most quit attempts involve a more gradual cessation. Characteristics of individuals who tend to reduce prior to quitting and the effectiveness of pre-quit reduction are not well understood. This study examined individual differences and smoking cessation outcomes between individuals who self-initiated gradual reduction in cigarettes per day (CPD) and those who did not reduce prior to quit date.

Methods

This study is a secondary analysis from a randomized clinical trial of smoking cessation with pharmacotherapy among individuals under community corrections supervision. We compared participants who self-initiated smoking reduction by at least 25% between baseline and the first treatment session (n = 128) to participants who either increased or did not reduce smoking between baseline and the first treatment session (n = 354).

Results

African American race, no previous cigar smoking, no previous use of pharmacotherapy for smoking cessation, less withdrawal symptoms at baseline, and older age at first smoking were associated with being a self-initiated gradual reduction in univariate analyses. Individuals who self-initiated gradual reduction also had a had a greater likelihood of achieving at least one quit during the one-year study period as compared to those who did not reduce prior to the intervention.

Conclusions

Individuals who self-initiate gradual reduction differ from those who increase or do not change their smoking prior to a quit date. Gradual reduction also increased success in quitting.

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Occupational exposure during endovascular aneurysm repair (EVAR) and aortoiliac percutaneous transluminal angioplasty (PTA) procedures

Abstract

Objectives

The purpose of this study was to determine the radiation exposure of primary interventionalist's different body parts during endovascular aneurysm repair (EVAR) procedures and aortoiliac percutaneous transluminal angioplasty (PTA) procedures and to evaluate the efficacy of a radioprotective drape.

Methods

Occupational doses for 36 consecutive aortoiliac PTA procedures and 17 consecutive EVAR procedures were estimated using thermoluminescence dosimetry (TLD) chips (TLD-200, Hashaw, Solon, OH). Effective dose (ED) was calculated using the Niklason algorithm. For the evaluation of a 0.25 mm Pb equivalent drape (Ecolab, Saint Paul, Minnesota, USA), experiments were performed using two physical anthropomorphic phantoms (Rando-Alderson Research Labs, CA, USA).

Results

Median ED for a typical EVAR and PTA procedure was 4.7 ± 1.4 μSv and 4.4 ± 3.6 μSv, respectively. The highest radiation doses were measured for the operator's hands in both procedures. Moreover, considerable doses were measured to the operator's head, eye lenses and thyroid. Due to the use of the drape, radiation exposure of primary operator's abdominal area, genitals, thyroid and eye lenses was reduced by an average of 59%, 60%, 65% and 59%, respectively. However, dose area product (DAP) and peak skin dose (PSD) were increased by 20% when part of the drape was placed into the X-ray field.

Conclusion

During EVAR and PTA procedures, primary operator's organs are exposed to considerable radiation doses. Occupational radiation exposure can be reduced significantly with the proper use of a radioprotective drape.

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The war on antidepressants: What we can, and can't conclude, from the systematic review of antidepressant withdrawal effects by Davies and Read

Publication date: Available online 23 January 2019

Source: Addictive Behaviors

Author(s): Sameer Jauhar, Joseph Hayes

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Endorsement of the “firewater myth” affects the use of protective behavioral strategies among American Indian and Alaska native students

Publication date: Available online 22 January 2019

Source: Addictive Behaviors

Author(s): Vivian M. Gonzalez, Adrian J. Bravo, Maria C. Crouch, Protective Strategies Study Team

Abstract

Belief in an American Indian/Alaska Native (AI/AN) specific biological vulnerability (BV) to alcohol problems (aka the "firewater myth") has been found to be associated with worse alcohol outcomes among AI/AN college students who drink, despite also being associated with greater attempts to reduce drinking. In the current study, we examined the associations of belief in a BV and belief that AI/AN people have more alcohol problems with the use of alcohol protective behavioral strategies (PBS) among AI/AN college students. PBS examined, as measured by the Protective Behavioral Strategies Scale-20, included manner of drinking, limiting/stopping drinking, and serious harm reduction strategies. Participants were college students who identified being AI/AN (n = 137) and had drank in the past month, and were selected from a larger multi-site study on PBS. Mediation models revealed that greater belief in a BV and belief that AI/AN people have more alcohol problems were both negatively associated with manner of drinking, which in turn was associated with greater past month alcohol use and alcohol consequences. These beliefs were not significantly associated with other PBS. Consistent with prior research with other student populations, both manner of drinking and limiting/stopping drinking were associated with less alcohol use and all three domains of PBS were directly associated with fewer alcohol consequences. The results suggest that these beliefs regarding AI/AN people and alcohol negatively affect the use of strategies aimed at avoiding drinking behavior that can lead to rapid drinking and a higher blood alcohol content, contributing to alcohol consequences.

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Self-initiated gradual smoking reduction among community correction smokers

Publication date: Available online 22 January 2019

Source: Addictive Behaviors

Author(s): Mickeah J. Hugley, Caitlin Wolford-Clevenger, Michelle L. Sisson, Angela T. Nguyen, Karen L. Cropsey

Abstract

Introduction

Smoking remains the leading cause of preventable death in the United States. Many smoking cessation guidelines advise smokers to quit precipitately; however, most quit attempts involve a more gradual cessation. Characteristics of individuals who tend to reduce prior to quitting and the effectiveness of pre-quit reduction are not well understood. This study examined individual differences and smoking cessation outcomes between individuals who self-initiated gradual reduction in cigarettes per day (CPD) and those who did not reduce prior to quit date.

Methods

This study is a secondary analysis from a randomized clinical trial of smoking cessation with pharmacotherapy among individuals under community corrections supervision. We compared participants who self-initiated smoking reduction by at least 25% between baseline and the first treatment session (n = 128) to participants who either increased or did not reduce smoking between baseline and the first treatment session (n = 354).

Results

African American race, no previous cigar smoking, no previous use of pharmacotherapy for smoking cessation, less withdrawal symptoms at baseline, and older age at first smoking were associated with being a self-initiated gradual reduction in univariate analyses. Individuals who self-initiated gradual reduction also had a had a greater likelihood of achieving at least one quit during the one-year study period as compared to those who did not reduce prior to the intervention.

Conclusions

Individuals who self-initiate gradual reduction differ from those who increase or do not change their smoking prior to a quit date. Gradual reduction also increased success in quitting.

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Our experience of shorter stay and lower cost for local versus general anaesthetic placement of tracheoesphageal fistulae in 27 patients

Abstract

Secondary trache‐oesophageal puncture and fistula formation is often undertaken after laryngectomy to restore voice.

The procedure was historically carried out under general anaesthesia (GA).

This has been largely supplanted by local anaesthetic (LA) techniques as GA puts patients at a greater risk and the procedure is a more technically difficult undertaking.

LA techniques have, however, never been validated against GA techniques in terms of length of stay, cost and complication rates.

We compare a GA and an LA technique and found a shorter length of stay, reduced cost and similar complication profile.

This article is protected by copyright. All rights reserved.

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Recurrent Bell's palsy

Abstract

Objective

Although recurrent facial palsy was first reported in 1871, the etiology, definitions, classifications, pathogenesis, treatment options, and prognosis have not been clearly determined. There have been no systematic reviews and meta‐analyses of recurrent Bell's palsy. The purpose of this study was to evaluate the clinical manifestations of recurrent Bell's palsy through a systematic review and meta‐analysis.

Design

The SCOPUS, PubMed, Cochrane Library, and EBSCO databases were searched through May 1, 2018, using the search terms 'recurrent Bell's palsy' and 'recurrent facial palsy', for studies involving patients with recurrent Bell's palsy. Reference lists of eligible studies were also reviewed.

Results

A search of titles and abstracts in these four databases identified 222 studies; of these, 27 studies, involving 1,041 patients from 13 countries, were analyzed. The mean percentage of patients who experienced recurrence of Bell's palsy ranged from 0.8% to 19.4%. Five studies that included 191 patients were included in the meta‐analysis.

Conclusions

Among patients previously affected by Bell's palsy, the mean incidence of recurrent Bell's palsy was 6.5%. Sidedness of recurrent disease, relative to the side of the original disease, had no effect on patient prognosis. Of all patients with Bell's palsy, 66.0% recovered completely, with the recovery rate lower in patients with recurrent than with primary Bell's palsy.

This article is protected by copyright. All rights reserved.

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Validation of french versions of the facial disability index (fdi) and the facial clinimetric evaluation (face) scale, specific quality of life scales for peripheral facial palsy patients

Abstract

Objectives

To translate and validate French versions of two health‐related quality of life questionnaires for patients with peripheral facial palsy: Facial Disability Index (FDI) and Facial Clinimetric Evaluation (FaCE) scale.

Design

Prospective cohort study.

Setting

University tertiary referral center.

Participants

A pilot test was performed on 10 subjects (5 patients with facial palsy of more than 1‐month duration and 5 normal subjects), then 67 adult patients with facial palsy were enrolled in the validation study.

Main outcome measures

Translation of the original questionnaires has followed international guidelines using a forward‐backward translation method. A pilot test and a validation study based on the translated questionnaires were performed. Internal consistency, test–retest reliability, validity and responsiveness were assessed. Validity was assessed by comparing to SF‐36 and Sunnybrook/House‐Brackmann grading systems. Subjects answered scales twice within a one‐week interval.

Results

67 patients were enrolled, among which 63 completed scales one week later (retest). For physical and social functions of FDI and FaCE scores, Cronbach's α representing internal consistency were 0.88, 0.70 and 0.89, and test–retest reliability by intra‐class correlation coefficients were 0.81, 0.86 and 0.89 respectively. The correlation of facial movement score of FaCE scale was good with Sunnybrook/House‐Brackmann grading systems (0.73 and ‐0.75, p<0.01). The correlation of social function of FaCE scale was excellent with social function of SF‐36 (0.8, p<0.01).

Conclusions

French versions of FDI and FaCE scale are psychometrically valid. Both questionnaires can be used for clinical studies to assess the quality of life of patients with peripheral facial palsy.

This article is protected by copyright. All rights reserved.

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Our experience of shorter stay and lower cost for local versus general anaesthetic placement of tracheoesphageal fistulae in 27 patients

Abstract

Secondary trache‐oesophageal puncture and fistula formation is often undertaken after laryngectomy to restore voice.

The procedure was historically carried out under general anaesthesia (GA).

This has been largely supplanted by local anaesthetic (LA) techniques as GA puts patients at a greater risk and the procedure is a more technically difficult undertaking.

LA techniques have, however, never been validated against GA techniques in terms of length of stay, cost and complication rates.

We compare a GA and an LA technique and found a shorter length of stay, reduced cost and similar complication profile.

This article is protected by copyright. All rights reserved.

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Recurrent Bell's palsy

Abstract

Objective

Although recurrent facial palsy was first reported in 1871, the etiology, definitions, classifications, pathogenesis, treatment options, and prognosis have not been clearly determined. There have been no systematic reviews and meta‐analyses of recurrent Bell's palsy. The purpose of this study was to evaluate the clinical manifestations of recurrent Bell's palsy through a systematic review and meta‐analysis.

Design

The SCOPUS, PubMed, Cochrane Library, and EBSCO databases were searched through May 1, 2018, using the search terms 'recurrent Bell's palsy' and 'recurrent facial palsy', for studies involving patients with recurrent Bell's palsy. Reference lists of eligible studies were also reviewed.

Results

A search of titles and abstracts in these four databases identified 222 studies; of these, 27 studies, involving 1,041 patients from 13 countries, were analyzed. The mean percentage of patients who experienced recurrence of Bell's palsy ranged from 0.8% to 19.4%. Five studies that included 191 patients were included in the meta‐analysis.

Conclusions

Among patients previously affected by Bell's palsy, the mean incidence of recurrent Bell's palsy was 6.5%. Sidedness of recurrent disease, relative to the side of the original disease, had no effect on patient prognosis. Of all patients with Bell's palsy, 66.0% recovered completely, with the recovery rate lower in patients with recurrent than with primary Bell's palsy.

This article is protected by copyright. All rights reserved.

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Validation of french versions of the facial disability index (fdi) and the facial clinimetric evaluation (face) scale, specific quality of life scales for peripheral facial palsy patients

Abstract

Objectives

To translate and validate French versions of two health‐related quality of life questionnaires for patients with peripheral facial palsy: Facial Disability Index (FDI) and Facial Clinimetric Evaluation (FaCE) scale.

Design

Prospective cohort study.

Setting

University tertiary referral center.

Participants

A pilot test was performed on 10 subjects (5 patients with facial palsy of more than 1‐month duration and 5 normal subjects), then 67 adult patients with facial palsy were enrolled in the validation study.

Main outcome measures

Translation of the original questionnaires has followed international guidelines using a forward‐backward translation method. A pilot test and a validation study based on the translated questionnaires were performed. Internal consistency, test–retest reliability, validity and responsiveness were assessed. Validity was assessed by comparing to SF‐36 and Sunnybrook/House‐Brackmann grading systems. Subjects answered scales twice within a one‐week interval.

Results

67 patients were enrolled, among which 63 completed scales one week later (retest). For physical and social functions of FDI and FaCE scores, Cronbach's α representing internal consistency were 0.88, 0.70 and 0.89, and test–retest reliability by intra‐class correlation coefficients were 0.81, 0.86 and 0.89 respectively. The correlation of facial movement score of FaCE scale was good with Sunnybrook/House‐Brackmann grading systems (0.73 and ‐0.75, p<0.01). The correlation of social function of FaCE scale was excellent with social function of SF‐36 (0.8, p<0.01).

Conclusions

French versions of FDI and FaCE scale are psychometrically valid. Both questionnaires can be used for clinical studies to assess the quality of life of patients with peripheral facial palsy.

This article is protected by copyright. All rights reserved.

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A fiber coherence index for quality control of B-table orientation in diffusion MRI scans

Publication date: Available online 22 January 2019

Source: Magnetic Resonance Imaging

Author(s): Kurt G. Schilling, Fang-Cheng Yeh, Vishwesh Nath, Colin Hansen, Owen Williams, Susan Resnick, Adam W. Anderson, Bennett A. Landman

Abstract

Purpose

The diffusion MRI "b-vector" table describing the diffusion sensitization direction can be flipped and permuted in dimension due to different orientation conventions used in scanners and incorrect or improperly utilized file formats. This can lead to incorrect fiber orientation estimates and subsequent tractography failure. Here, we present an automated quality control procedure to detect when the b-table is flipped and/or permuted incorrectly.

Methods

We define a "fiber coherence index" to describe how well fibers are connected to each other, and use it to automatically detect the correct configuration of b-vectors. We examined the performance on 3981 research subject scans (Baltimore Longitudinal Study of Aging), 1065 normal subject scans of high image quality (Human Connectome Project), and 202 patient scans (Vanderbilt University Medical Center), as well as 9 in-vivo and 9 ex-vivo animal data.

Results

The coherence index resulted in a 99.9% (3979/3981) and 100% (1065/1065) success rate in normal subject scans, 98% (198/202) in patient scans, and 100% (18/18) in both in-vivo and ex-vivo animal data in detecting the correct gradient table in datasets without severe image artifacts. The four failing cases (4/202) in patient scans, and two failures in healthy subject scans (2/3981), all showed prominent motion or signal dropout artifacts.

Conclusions

The fiber coherence measure can be used as an automatic quality assurance check in any diffusion analysis pipeline. Additionally, the success of this fiber coherence measure suggests potential broader applications, including evaluating data quality, or even providing diagnostic value as a biomarker of white matter integrity.

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A fiber coherence index for quality control of B-table orientation in diffusion MRI scans

Publication date: Available online 22 January 2019

Source: Magnetic Resonance Imaging

Author(s): Kurt G. Schilling, Fang-Cheng Yeh, Vishwesh Nath, Colin Hansen, Owen Williams, Susan Resnick, Adam W. Anderson, Bennett A. Landman

Abstract

Purpose

The diffusion MRI "b-vector" table describing the diffusion sensitization direction can be flipped and permuted in dimension due to different orientation conventions used in scanners and incorrect or improperly utilized file formats. This can lead to incorrect fiber orientation estimates and subsequent tractography failure. Here, we present an automated quality control procedure to detect when the b-table is flipped and/or permuted incorrectly.

Methods

We define a "fiber coherence index" to describe how well fibers are connected to each other, and use it to automatically detect the correct configuration of b-vectors. We examined the performance on 3981 research subject scans (Baltimore Longitudinal Study of Aging), 1065 normal subject scans of high image quality (Human Connectome Project), and 202 patient scans (Vanderbilt University Medical Center), as well as 9 in-vivo and 9 ex-vivo animal data.

Results

The coherence index resulted in a 99.9% (3979/3981) and 100% (1065/1065) success rate in normal subject scans, 98% (198/202) in patient scans, and 100% (18/18) in both in-vivo and ex-vivo animal data in detecting the correct gradient table in datasets without severe image artifacts. The four failing cases (4/202) in patient scans, and two failures in healthy subject scans (2/3981), all showed prominent motion or signal dropout artifacts.

Conclusions

The fiber coherence measure can be used as an automatic quality assurance check in any diffusion analysis pipeline. Additionally, the success of this fiber coherence measure suggests potential broader applications, including evaluating data quality, or even providing diagnostic value as a biomarker of white matter integrity.

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The Diagnostic Value of 4D MRI at 3T for the Localization of Parathyroid Adenomas

Publication date: Available online 22 January 2019

Source: European Journal of Radiology

Author(s): Mesut Ozturk, Ahmet Veysel Polat, Cetin Celenk, Muzaffer Elmali, Seher Kir, Cafer Polat

Abstract

Purpose

The aim of this study was to assess the feasibility of four-dimensional magnetic resonance imaging (4D MRI) at 3 T for the localization of parathyroid adenomas.

Materials and Methods

Preoperative 4D MRI scans, encompassing dynamic contrast-enhanced (DCE) sequences and non-contrast enhanced (non-CE) sequences, including a T2-weighted multipoint Dixon (T2-mDixon) sequence, with in-phase, out-phase, and water-only images, were evaluated retrospectively in 41 patients with surgically proven parathyroid lesions. Two readers who were blinded to the surgical findings independently reviewed the images in two sessions (non-CE sequences alone and non-CE + DCE sequences). The MRI localization of the suspected adenoma in each session and the consensus interpretation of the MRI images, were compared with the surgical results and interobserver agreement was assessed.

Results

By interpreting the non-CE sequences alone, reader 1 correctly localized 34 parathyroid lesions (sensitivity 81.0%, positive predictive value (PPV) 87.2%), and reader 2 correctly localized 34 parathyroid lesions (sensitivity 81.0%, PPV 91.9%). With the addition of DCE sequences, reader 1 correctly identified 35 parathyroid lesions (sensitivity 83.3%, PPV 87.5%), while reader 2 correctly identified 36 parathyroid lesions (sensitivity 85.7%, PPV 92.3%). Overall, MRI detected 38 parathyroid lesions (sensitivity 90.5%, PPV 95.0%). Interobserver agreement was slightly superior in non-CE + DCE sequences compared to non-CE sequences alone (ĸ = 0.738 vs. ĸ = 0.796).

Conclusion

4D MRI with DCE sequencing is a reliable method for the localization of parathyroid adenomas.

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Development and Validation of a Radiomics Nomogram for Identifying Invasiveness of Pulmonary Adenocarcinomas Appearing as Subcentimeter Ground-glass Opacity Nodules

Publication date: Available online 22 January 2019

Source: European Journal of Radiology

Author(s): Wei Zhao, Ya'nan Xu, Zhiming Yang, Yingli Sun, Cheng Li, Liang Jin, Pan Gao, Wenjie He, Peijun Wang, Hongli Shi, Yanqing Hua, Ming Li

Abstract

The aim of the present study was to develop and validate a radiomics-based nomogram for differentiation of pre-invasive lesions from invasive lesions that appearing as ground-glass opacity nodules (GGNs) ≤10 mm (sub-centimeter) in diameter at CT. A total of 542 consecutive patients with 626 pathologically confirmed pulmonary subcentimeter GGNs were retrospectively studied from October 2011 to September 2017. All the GGNs were divided into a training set (n = 334) and a validation set (n = 292). Researchers extracted 475 radiomics features from the plain CT images; a radiomics signature was constructed with the least absolute shrinkage and selection operator (LASSO) based on multivariable regression in the training set. Based on the multivariable logistic regression model, a radiomics nomogram was developed in the training set. The performance of the nomogram was evaluated with respect to its calibration, discrimination, and clinical-utility and this was assessed in the validation set. The constructed radiomics signature, which consisted of 15 radiomics features, was significantly associated with the invasiveness of subcentimeter GGNs (P < 0.0001 for both training set and validation set). To build the nomogram model, radiomics signature and mean CT value were used. The nomogram model demonstrated good discrimination and calibration in both training set (C-index, 0.716 [95% CI, 0.632 to 0.801]) and validation set (C-index, 0.707 [95% CI, 0.625 to 0.788]). Decision curve analysis (DCA) indicated that radiomics-based nomogram was clinically useful. A radiomics-based nomogram that incorporates both radiomics signature and mean CT value is constructed in the study, which can be conveniently used to facilitate the preoperative individualized prediction of the invasiveness in patients with subcentimeter GGNs.

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Whole-tumor histogram analysis of apparent diffusion coefficient in differentiating intracranial solitary fibrous tumor/hemangiopericytoma from angiomatous meningioma

Publication date: Available online 22 January 2019

Source: European Journal of Radiology

Author(s): Wenle He, Xiang Xiao, Xiaodan Li, Yihao Guo, Liuji Guo, Xiaomin Liu, Yikai Xu, Jun Zhou, Yuankui Wu

Abstract

Purpose

To assess the role of histogram analysis of apparent diffusion coefficient (ADC) maps based on whole-tumor in differentiating intracranial solitary fibrous tumor/hemangiopericytoma (SFT/HPC) from angiomatous meningioma (AM).

Materials and methods

Pathologically confirmed intracranial SFT/HPC (n = 15) and AM (n = 20) were retrospectively collected and their clinical and conventional MRI features were analyzed. Diffusion-weighted (DW) images (b = 0 and 1000s/mm²) were processed with the mono-exponential model. Regions of interest covering the whole tumor were drawn on all slices of the ADC maps to obtain histogram parameters, including mean ADC (ADCmean), median ADC (ADCmedian), maximum ADC (ADCmax), minimum ADC (ADCmin), skewness and kurtosis, as well as the 5^th, 10^th, 25^th, 75^th, 90^th and 95^th percentile ADC (ADC5, ADC10, ADC25, ADC75, ADC90 and ADC95). Differences of histogram parameters between SFT/HPC and AM were compared using Mann-Whitney U test. Receiver operating characteristic (ROC) curves was used to determine the diagnostic performance.

Results

The ADCmin (P=0.001) and ADC5 (P = 0.045) were significantly lower in SFT/HPCs than in AMs, while no significant difference was found in sex, age, conventional MRI features or any other histogram parameters between the two entities (P=0.051-1.000). ADCmin showed the best diagnostic performance (area under curves [AUC], 0.86; sensitivity, 81.3%; specificity, 83.3%) in differentiating SFT/HPC from AM with optimal cutoff value being 569.00 × 10^-6  mm²/s, followed by ADC5 (AUC, 0.72; sensitivity, 68.8%; specificity, 75 %) with optimal cutoff value being 781.97 × 10^-6  mm²/s.

Conclusion

SFT/HPC and AM share similar conventional MR appearances. Whole-tumor histogram analysis of ADC maps may be a useful tool for differential diagnosis, with ADCmin and ADC5 being potential parameters.

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Effects of Vaginal Seeding on Infants' Body Mass Index and Allergy Risk for Caesarean-delivered Children

Conditions:   Overweight and Obesity;   Allergy Intervention:   Procedure: Vaginal seeding Sponsors:   Peking University;   National Natural Science Foundation of China;   Liuyang Maternal and Child Health Care Hospital Recruiting (Source: ClinicalTrials.gov)

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A Randomized Experiment of Malaria Diagnostic Testing and Conditional Subsidies to Target ACTs in the Retail Sector: the TESTsmART Trial Aim 1

Conditions:   Malaria;   Febrile Illness Interventions:   Other: Conditional ACT subsidy, Arm 1 levels;   Other: Conditional ACT subsidy, Arm 2 levels;   Other: Conditional ACT subsidy, Arm 3 levels;   Other: Conditional ACT subsidy, Arm 4 levels Sponsors:   Duke University;   National Institute of Allergy and Infectious Diseases (NIAID);   Moi University;   Clinton Health Access Initiative, Nigeria Not yet recruiting (Source: ClinicalTrials.gov)

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The Diagnostic Value of 4D MRI at 3T for the Localization of Parathyroid Adenomas

Publication date: Available online 22 January 2019

Source: European Journal of Radiology

Author(s): Mesut Ozturk, Ahmet Veysel Polat, Cetin Celenk, Muzaffer Elmali, Seher Kir, Cafer Polat

Abstract

Purpose

The aim of this study was to assess the feasibility of four-dimensional magnetic resonance imaging (4D MRI) at 3 T for the localization of parathyroid adenomas.

Materials and Methods

Preoperative 4D MRI scans, encompassing dynamic contrast-enhanced (DCE) sequences and non-contrast enhanced (non-CE) sequences, including a T2-weighted multipoint Dixon (T2-mDixon) sequence, with in-phase, out-phase, and water-only images, were evaluated retrospectively in 41 patients with surgically proven parathyroid lesions. Two readers who were blinded to the surgical findings independently reviewed the images in two sessions (non-CE sequences alone and non-CE + DCE sequences). The MRI localization of the suspected adenoma in each session and the consensus interpretation of the MRI images, were compared with the surgical results and interobserver agreement was assessed.

Results

By interpreting the non-CE sequences alone, reader 1 correctly localized 34 parathyroid lesions (sensitivity 81.0%, positive predictive value (PPV) 87.2%), and reader 2 correctly localized 34 parathyroid lesions (sensitivity 81.0%, PPV 91.9%). With the addition of DCE sequences, reader 1 correctly identified 35 parathyroid lesions (sensitivity 83.3%, PPV 87.5%), while reader 2 correctly identified 36 parathyroid lesions (sensitivity 85.7%, PPV 92.3%). Overall, MRI detected 38 parathyroid lesions (sensitivity 90.5%, PPV 95.0%). Interobserver agreement was slightly superior in non-CE + DCE sequences compared to non-CE sequences alone (ĸ = 0.738 vs. ĸ = 0.796).

Conclusion

4D MRI with DCE sequencing is a reliable method for the localization of parathyroid adenomas.

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