European Radiology

Fanelli, Fabrizio; Cannavale, Alessandro

doi: 10.1007/s00330-014-3094-0pmid: 24477689

To analyse data comparing drug-eluting devices versus non-coated devices in the treatment of vascular disease in the infrapopliteal region. All data available in the literature (16 studies were included) comparing drug-eluting stents (DESs) and drug-eluting balloons (DEBs) versus bare-metal stents (BMSs) and conventional balloons were analysed. For each single study, primary and secondary endpoints were reported. As comparative studies between DEBs and DESs were not available, a technical evaluation of the advantages and disadvantages of both were also included. Besides the limitations of the published studies, all of them were reporting interesting results for the new generation devices (DEB and DES). DES: primary patency at 1 year comprised between 75.0 % and 86 %; target lesion revascularisation between 8.7 % and 13.8 %. DEB: primary patency comprised between 71 % and 84.6 % at 12 months; target lesion revascularisation between 15.3 % and 17.6 %. However, limb salvage rates were not always higher using a DEB rather than a standard percutaneous transluminal angioplasty (PTA); a clinical improvement for patients treated with DEB was demonstrated only in the Leipzig registry. On the basis of the results available, the drug-eluting devices produced better results. DEB can be considered the leading approach in below-the-knee disease. A comparative evaluation with DES is mandatory in the future.

Spagnolo, Paolo; Sverzellati, Nicola; Wells, Athol; Hansell, David

doi: 10.1007/s00330-013-3088-3pmid: 24399491

Sarcoidosis is a systemic granulomatous disorder of unknown aetiology with a wide spectrum of radiological appearances and almost invariably pulmonary involvement. Lung involvement accounts for most of the morbidity and much of the mortality associated with sarcoidosis. Imaging contributes significantly to the diagnosis and management of patients with sarcoidosis. In typical cases, chest radiography may be sufficient to establish the diagnosis with little margin of error and CT is not necessary. However, CT can play a critical role in several clinical settings: atypical clinical and/or radiographic findings; normal or near-normal chest radiograph but clinical suspicion of sarcoidosis; and detection of complications. Moreover, in many patients, CT findings are atypical and unfamiliar to most radiologists (e.g. sarcoidosis mimicking other lung diseases and vice versa), and in these cases histological confirmation of the diagnosis is recommended. CT is also useful in assessing disease extent and may help to discriminate between reversible and irreversible lung disease, thus providing critical prognostic information. This review concentrates on the more difficult imaging aspects of sarcoidosis, in particular differential diagnosis and disease complications.

Lee, So; Kim, Yookyung; Shim, Sung; Lee, Jeong; Lee, Seok; Ryu, Yon; Chang, Jung

doi: 10.1007/s00330-013-3090-9pmid: 24442444

• Iterative reconstruction enables ultra-low-dose CT (ULDCT) with very low radiation doses. • Image quality of ULDCT depends on the patient body mass index (BMI). • Selection of kVp and mAs depends on both BMI and lesion type. • Diagnosis of pulmonary emphysema or ground-glass nodules requires higher radiation doses.

Baum, Thomas; Bauer, Jan; Klinder, Tobias; Dobritz, Martin; Rummeny, Ernst; Noël, Peter; Lorenz, Cristian

doi: 10.1007/s00330-013-3089-2pmid: 24425527

• This spine segmentation algorithm automatically localised, identified, and segmented the vertebrae in MDCT images . • Osteoporotic vertebral fractures could be automatically detected using this prototype algorithm . • The prototype algorithm helps radiologists to report underdiagnosed osteoporotic vertebral fractures .

Svahn, Tony

doi: 10.1007/s00330-013-3091-8pmid: 24458859

Lei, Junqiang; Yang, Pin; Zhang, Li; Wang, Yinzhong; Yang, Kehu

doi: 10.1007/s00330-013-3092-7pmid: 24442445

Simons, David; Kachelrieß, Marc; Schlemmer, Heinz-Peter

doi: 10.1007/s00330-013-3087-4pmid: 24402123

Dual-energy computed tomography (DECT) can amply contribute to support oncological imaging: the DECT technique offers promising clinical applications in oncological imaging for tumour detection and characterisation while concurrently reducing the radiation dose. Fast image acquisition at two different X-ray energies enables the determination of tissue- or material-specific features, the calculation of virtual unenhanced images and the quantification of contrast medium uptake; thus, tissue can be characterised and subsequently monitored for any changes during treatment. DECT is already widely used, but its potential in the context of oncological imaging has not been fully exploited yet. The technology is the subject of ongoing innovation and increasingly with respect to its clinical potential, particularly in oncology. This review highlights recent state-of-the-art DECT techniques with a strong emphasis on ongoing DECT developments relevant to oncologic imaging, and then focuses on clinical DECT applications, especially its prospective uses in areas of oncological imaging. Key Points • Dual - energy CT ( DECT ) offers fast , robust , quantitative and functional whole - body imaging . • DECT provides improved tumour detection and more detailed tissue differentiation and characterisation . • DECT affords therapy monitoring with complementary information and reduced radiation dose . • The use of DECT in oncology is of increasing clinical importance . • The potential of DECT in oncology has not been fully exploited yet .

Kim, David; Hinshaw, J.; Lubner, Meghan; Munoz del Rio, Alejandro; Pooler, B.; Pickhardt, Perry

doi: 10.1007/s00330-014-3095-zpmid: 24482303

Surface contrast coating is common for flat polyps at CTC, promoted by large size, proximal location and serrated/hyperplastic histology. Given the difficulty in detection, recognition may aid in flat polyp identification. Key points • Oral contrast coats the surface of most flat colorectal polyps at CT colonography . • Large size, proximal colonic location and serrated/hyperplastic histology increase polyp coating . • Contrast coating increases diagnostic confidence for flat polyps . • Contrast coating may help in flat polyp detection at CTC .

Park, Hyun; Kim, Seong; Jang, Kyung; Choi, Seo-youn; Lee, Soon; Choi, Dongil

doi: 10.1007/s00330-014-3097-xpmid: 24487774

Adding DWI to conventional MRI is more helpful for differentiating benign from malignant bile duct strictures than conventional MRI alone. Key points • Accurate diagnosis and exclusion of benign strictures of bile duct are important. • Diffusion-weighted MRI helps to distinguish benign from malignant bile duct strictures. • DWI plus conventional MRI provides superior diagnostic accuracy to conventional MRI alone.

Ding, Ying; Rao, Sheng-Xiang; Meng, Tao; Chen, Caizhong; Li, Renchen; Zeng, Meng-Su

doi: 10.1007/s00330-014-3096-ypmid: 24463697

HBP T 1 relaxation time measurement of Gd-EOB-DTPA-enhanced MRI was useful to evaluate NAFLD according to the SAF score. HBP T 1 relaxation time measurement was as accurate as ∆% T 1 relaxation time. Key Points • Gd-EOB-DTPA-enhanced MRI could give useful information on NAFLD . • HBP T 1 relaxation time measurement was useful for the evaluation of NAFLD . • HBP T 1 relaxation time measurement was as accurate as ∆%.