The natural course of native kidneys after hemodialysis initiation in patients with autosomal dominant polycystic kidney disease (ADPKD) remains poorly understood.
We measured the total volumes of native kidneys in 12 patients who had at least one enhanced computed tomography (CT) image both before and after initiation of hemodialysis (group 1) and in 18 patients who had no image before dialysis but more than two images after dialysis (group 2). In patients with images, the last image was used for analysis only after dialysis.
The mean total kidney volume (TKV) (± SD) before hemodialysis initiation was 3132 ± 1413 mL and the mean TKV of the last image was 3047 ± 1323 mL in group 1. The mean TKV change rate (%) was −5.2 ± 27.4% (
The results suggest that the TKV of native polycystic kidneys decreases substantially after hemodialysis initiation. This reduction occurs mainly during the early post-hemodialysis period and followed by a slow enlargement of TKV.
Identification of axillary metastases in breast cancer is important for staging disease and planning treatment, but current techniques are associated with a number of adverse events. This report evaluates the diagnostic accuracy of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) techniques for identification of axillary metastases in breast cancer patients.
We performed a meta-analysis of previous studies that compared SPIO enhanced MRI with histological diagnosis after surgery or biopsy. We searched PubMed, Ovid, Springer Link, and Cochrane library to identify studies reporting data for SPIO enhanced MRI for detection of axillary lymph node metastases in breast cancer until December 2013. The following keywords were used: “magnetic resonance imaging AND axilla” and “superparamagnetic iron oxide AND axilla”. Eligible studies were those that compared SPIO enhanced MRI with histological diagnosis. Sensitivity and specificity were calculated for every study; summary receiver operating characteristic and subgroup analyses were done. Study quality and heterogeneity were also assessed.
There were 7 publications that met the criteria for inclusion in our meta-analysis. SROC curve analysis for per patient data showed an overall sensitivity of 0.83 (95% Confidence interval (CI): 0.75–0.89) and overall specificity of 0.97 (95% CI: 0.94–0.98). Overall weighted area under the curve was 0.9563.
SPIO enhanced MRI showed a trend toward high diagnostic accuracy in detection of lymph node metastases for breast cancer. So, when the breast cancer patients has axillary metastases histologically, SPIO enhanced MRI may be effective diagnostic imaging modality for axillary metastases.
The purpose of this study was to evaluate the performance of half-dose chest CT using an iterative reconstruction technique in patients with lung malignancies.
The Dual-source CT scans were obtained and half-dose datasets were reconstructed with 5 different strengths in 38 adults with lung malignancies. Two radiologists graded subjective image quality; noise, contrast and sharpness at the central/peripheral lung, mediastinum and chest wall of the reconstructed half-dose images, compared with those of standard-dose images, using a three-point scale. A lesion assessment; lesion conspicuity and diagnostic confidence, was also performed. The quantitative image noises; contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) were measured and compared with those of standard-dose images.
The subjective image noise in the half-dose images was less than that of the standard-dose images. The contrast in strengths 2 to 5 was superior, the sharpness of the lung parenchyma in strengths 3 to 5 was inferior, and the CNR/SNR in all strengths were higher than those of standard-dose images (
Half-dose chest CT images using an iterative reconstruction technique show decreased image noise, increased contrast, and diagnostic confidence comparable to standard-dose images. Images reconstructed with strength 2 and 3 appear to be the optimal choice in clinical practice.