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OPEN ACCESS PLUS
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Contents
8(2): Pp. 107 - 116
Nils Albiin
[Open Access Plus] |
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Magnetic resonance imaging, MRI has more advantages than ultrasound, computed tomography, CT, positron emission tomography, PET, or any other imaging modality in diagnosing focal hepatic masses. With a combination of basic T1 and T2 weighted sequences, diffusion weighted imaging, DWI, and hepatobiliary gadolinium contrast agents, that is gadobenate dimeglumine (Gd-BOPTA) and gadoxetic acid (Gd-EOB), most liver lesions can be adequately diagnosed. Benign lesions, as cyst, hemangioma, focal nodular hyperplasia, FNH or adenoma, can be distinguished from malignant lesions. In a non-cirrhotic liver, the most common malignant lesions are metastases which may be hypovascular or hypervascular. In the cirrhotic liver hepatocellular carcinoma, HCC, is of considerable importance. Besides, intrahepatic cholangiocarcinoma and other less common malignancies has to be assessed. In this review, the techniques and typical MRI features are presented as well as the new algorithm issued by American Association for the Study of the Liver Diseases (AASLD).
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5(2): Pp. 110 - 127
Rossella Canese, Egidio Iorio, Alessandro Ricci, Maria Elena Pisanu, Massimo Giannini and Franca Podo
[Open Access Plus] |
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Magnetic resonance spectroscopy (MRS) allows non invasive detection of tissue metabolism. Absolute or relative quantification of metabolites and chemical compounds detected by 1H and 31P MRS can today be performed in a number of pathological tissues including different types of cancer lesions, consequently improving accuracy in disease diagnosis and prognosis. Methods allowing quantification of tumour metabolites under in vivo MR spectral profiles have been progressively developed in the past and are now entering the clinical routine. Several methods of quantification have been proposed and validated in healthy tissues in a number of single- and multi-centre studies. Most of these approaches are not always directly applicable to cancer lesions because of their inherent heterogeneity or variability in water content, thus peak area ratios can, in some cases, represent better indicators of disease progression and response to therapy. An additional important limitation may derive from the excessive duration of some MRS measurement protocols, which would be added to a routine clinical MRI examination in the same session. We propose a critical overview of the principal methods currently applied for the quantification of metabolites and chemical compounds, mostly detected by 1H MRS in tumours.
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3(2): Pp. 123 - 137
Franca Podo, Francesco Sardanelli, Egidio Iorio, Rossella Canese, Giulia Carpinelli, Alfonso Fausto and Silvana Canevari
[Open Access Plus] |
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Elevated contents of choline phospholipid metabolites are typically detected by nuclear magnetic resonance spectroscopy (MRS) in human and animal tumors. An increase in the intensity of the 1H-MRS profile of total cholinecontaining compounds (tCho, 3.2 ppm) is today considered as a common feature in different types of cancer, beyond their otherwise wide phenotypic variability. This finding fostered investigations on the molecular mechanisms underlying the observed spectral changes and on correlations between aberrant phospholipid metabolism and tumor progression. At the clinical level, efforts are addressed to evaluate effectiveness and potential use of in vivo localized MRS and choline-based positron emission tomography (Cho-PET) in cancer diagnosis. Aims of this article are: a) to overview recent advances in the identification of biochemical pathways responsible for the altered 1H-MRS tCho profile in breast and ovary cancer cells, as a basis for interpreting in vivo MR spectra and enhanced uptake of radiolabeled choline in PET; b) to summarize recent developments of in vivo 1H-MRS methods in breast cancer diagnosis; c) to discuss the potentialities of complementing current diagnostic modalities with noninvasive MRS and Cho-PET methods to monitor biochemical alterations associated with progression, relapse and therapy response in ovary cancer.
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