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Find video protocols related to scientific articles indexed in Pubmed.
ACR Appropriateness Criteria® Right Lower Quadrant Pain-Suspected Appendicitis.
Ultrasound Q
PUBLISHED: 11-04-2014
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The most common cause of acute right lower quadrant (RLQ) pain requiring surgery is acute appendicitis (AA). This narrative's focus is on imaging procedures in the diagnosis of AA, with consideration of other diseases causing RLQ pain. In general, Computed Tomography (CT) is the most accurate imaging study for evaluating suspected AA and alternative etiologies of RLQ pain. Data favor intravenous contrast use for CT, but the need for enteric contrast when intravenous contrast is used is not strongly favored. Radiation exposure concerns from CT have led to increased investigation in minimizing CT radiation dose while maintaining diagnostic accuracy and in using algorithms with ultrasound as a first imaging examination followed by CT in inconclusive cases. In children, ultrasound is the preferred initial examination, as it is nearly as accurate as CT for the diagnosis of AA in this population and without ionizing radiation exposure. In pregnant women, ultrasound is preferred initially with MRI as a second imaging examination in inconclusive cases, which is the majority.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
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History, evolution, and current status of radiologic imaging tests for colorectal cancer screening.
Radiology
PUBLISHED: 10-24-2014
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Colorectal cancer screening is thought to be an effective tool with which to reduce the mortality from colorectal cancer through early detection and removal of colonic adenomas and early colon cancers. In this article, we review the history, evolution, and current status of imaging tests of the colon-including single-contrast barium enema, double-contrast barium enema, computed tomographic (CT) colonography, and magnetic resonance (MR) colonography-for colorectal cancer screening. Despite its documented value in the detection of colonic polyps, the double-contrast barium enema has largely disappeared as a screening test because it is widely perceived as a labor-intensive, time-consuming, and technically demanding procedure. In the past decade, the barium enema has been supplanted by CT colonography as the major imaging test in colorectal cancer screening in the United States, with MR colonography emerging as another viable option in Europe. Although MR colonography does not require ionizing radiation, the radiation dose for CT colonography has decreased substantially, and regular screening with this technique has a high benefit-to-risk ratio. In recent years, CT colonography has been validated as an effective tool for use in colorectal cancer screening that is increasingly being disseminated. © RSNA, 2014 Listen to a discussion of the history of radiology.
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Hepatobiliary agents and their role in LI-RADS.
Abdom Imaging
PUBLISHED: 10-08-2014
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The Liver Imaging Reporting and Data System (LI-RADS) was introduced with the goal of standardizing the diagnosis of hepatocellular carcinoma. The 2014 version of LI-RADS incorporates the use of hepatobiliary contrast agents (HBAs) into the diagnostic algorithm, including gadoxetate disodium and gadobenate dimeglumine. Three new ancillary features are introduced: hepatobiliary phase (HBP) hypointensity and HBP hypointense rim favor malignancy, while HBP isointensity favors benignity. HBP hyperintensity favors neither malignancy nor benignity. In this review, we describe how to use these new features as well as numerous pitfalls associated with the use ofHBAs, including hemangiomas, cholangiocarcinomas, and focal confluent fibrosis. Importantly, findings on the HBP are not included as major criteria and therefore the criteria for the diagnosis of LI-RADS 5 observations remain unchanged, and so congruence with the Organ Procurement Transplant Network system remains intact. Additionally, we review how the major features in LI-RADS, arterial phase hyperenhancement, threshold growth, and washout and capsule appearance, may be affected with HBAs. Notably with HBAs, hypointensity on the delayed phase, termed the transitional phase, does not qualify as washout appearance due to the possibility of early parenchymal enhancement. It is hoped that the incorporation of HBAs into LI-RADS will help create consistency when interpreting HBA enhanced MRIs.
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Neuroendocrine Tumors: Beyond the Abdomen.
J Comput Assist Tomogr
PUBLISHED: 08-28-2014
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Several classification systems for neuroendocrine tumors (NETs) exist, which use variable terminology and criteria for grading and staging. This variability in terminology can cause confusion and difficulty in recognizing which tumors are, in fact, members of this heterogeneous group of malignancies. The largest group of NETs, the gastroenteropancreatic NETs, has been well described and characterized; however, there are less-recognized extra-abdominal NETs that can arise from nearly any organ in the body. In this article, the clinical features and imaging appearances of the extra-abdominal NETs will be reviewed, compared, and contrasted. This diverse group consists of paragangliomas, Merkel cell carcinomas, esthesioneuroblastomas, NETs of the lung, and medullary thyroid carcinomas. Recognition of these tumors as part of the larger group of NETs is important for understanding how best to approach imaging for their diagnosis, staging, and potential treatment. Familiarity with the computed tomographic and magnetic resonance imaging appearances and the role of radionuclide imaging of these heterogeneous groups aids in the correct diagnosis and in treatment planning.
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ACR Appropriateness Criteria colorectal cancer screening.
J Am Coll Radiol
PUBLISHED: 02-18-2014
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Colorectal cancer is the third leading cause of cancer deaths in the United States. Most colorectal cancers can be prevented by detecting and removing the precursor adenomatous polyp. Individual risk factors for the development of colorectal cancer will influence the particular choice of screening tool. CT colonography (CTC) is the primary imaging test for colorectal cancer screening in average-risk individuals, whereas the double-contrast barium enema (DCBE) is now considered to be a test that may be appropriate, particularly in settings where CTC is unavailable. Single-contrast barium enema has a lower performance profile and is indicated for screening only when CTC and DCBE are not available. CTC is also the preferred test for colon evaluation following an incomplete colonoscopy. Imaging tests including CTC and DCBE are not indicated for colorectal cancer screening in high-risk patients with polyposis syndromes or inflammatory bowel disease. This paper presents the updated colorectal cancer imaging test ratings and is the result of evidence-based consensus by the ACR Appropriateness Criteria Expert Panel on Gastrointestinal Imaging. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
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Patient-tailored scan delay for multiphase liver CT: improved scan quality and lesion conspicuity with a novel timing bolus method.
AJR Am J Roentgenol
PUBLISHED: 01-24-2014
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The purpose of this study was to compare scan quality and lesion conspicuity for late arterial and portal venous phase liver CT scans using fixed versus patient-tailored scan delay derived with an evidence-based timing bolus method.
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Prevalence and significance of perivascular soft tissue surrounding the hepatic artery after liver transplantation.
J Comput Assist Tomogr
PUBLISHED: 01-23-2014
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The objective of this study was to determine the prevalence and significance of perivascular soft tissue surrounding the hepatic artery on computed tomography (CT) after liver transplantation.
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Contrast-Enhanced CT Quantification of the Hepatic Fractional Extracellular Space: Correlation With Diffuse Liver Disease Severity.
AJR Am J Roentgenol
PUBLISHED: 11-23-2013
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OBJECTIVE. The purpose of this study was to determine whether contrast-enhanced CT quantification of the hepatic fractional extracellular space (ECS) correlates with the severity of diffuse liver disease. MATERIALS AND METHODS. The cases of 70 patients without (46 men, 24 women; mean age, 59.1 years) and 36 patients with (23 men, 13 women; mean age, 63.1 years) cirrhosis who had undergone unenhanced and 10-minute delayed phase contrast-enhanced CT were retrospectively identified. By consensus one experienced radiologist and one trainee measured the CT attenuation of the liver and aorta to estimate the fractional ECS, defined as the ratio of the difference between the attenuation of the liver on 10-minute and unenhanced images to the difference between the attenuation of the aorta on 10-minute and unenhanced images multiplied by 1 minus the hematocrit. Findings were correlated with each patients Model of End-Stage Liver Disease (MELD) score. RESULTS. The mean MELD score was higher in patients with than in those without cirrhosis (14.3 ± 7.3 versus 7.20 ± 2.4, p < 0.0001). The mean fractional ECS was significantly greater in patients with cirrhosis than in those without cirrhosis (41.0% ± 9.0% versus 23.8% ± 6.3%, p < 0.0001). The fractional ECS correlated with the MELD score (r = 0.572, p < 0.0001) and was predictive of cirrhosis with an area under the receiver operating characteristic curve of 0.953 (p < 0.0001). The sensitivity and specificity of an expanded fractional ECS greater than 30% for the prediction of cirrhosis were 92% and 83%. Multivariate linear regression revealed that the fractional ECS is complementary to the MELD score as a predictor of cirrhosis (p < 0.0001). CONCLUSION. Noninvasive contrast-enhanced CT quantification of the fractional ECS correlates with the MELD score, an indicator of the severity of liver disease, and merits further study.
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The Challenges of CT Colonography Reimbursement.
J Am Coll Radiol
PUBLISHED: 09-08-2013
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CT colonography has been shown to be an effective method to screen for colorectal cancer. However, at present, full endorsement and reimbursement for screening CT colonography, particularly by the US Preventive Services Task Force and CMS, respectively, are absent, so this screening option is infrequently used, and optical colonoscopy remains the de facto standard screening option. The authors summarize the past accomplishments that led to the current state of reimbursement and outline the remaining challenges and road to full acceptance and reimbursement of screening CT colonography nationally.
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Dose reduction methods for CT colonography.
Abdom Imaging
PUBLISHED: 09-04-2013
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Patients, referring physicians, the media, and government agencies have all expressed concern over the risks of medical radiation, particularly as it relates to CT. This concern is particularly paramount when associated with a screening examination such as CT colonography. These theoretical risks must be weighed realistically against the substantial benefits of colon cancer screening as well as against the risks inherent in the major alternative screening option, optical colonoscopy. When put into perspective, the risk-benefit ratio is highly in favor of the performance of CT colonography. Nevertheless, in following the ALARA principle, there is an ever increasing armamentarium of options that can be employed in the pursuit of CT radiation dose reduction, all of which can be used in many synergistic combinations allowing for dose reduction while simultaneously preserving image quality and minimizing image noise. After a brief tutorial on estimating radiation dose, various strategies will be discussed including reductions in tube current and tube voltage as well as the use of automatic dose modulation and iterative reconstruction. Other practical considerations will also be reviewed including proper patient isocentering, optimization of colonic insufflation to minimize additional decubitus scans, proper choice of scan volumes to avoid overranging, and variation of slice thickness and window width to minimize perceived image noise. Finally, a strategy for how to incrementally introduce these methods as well as a way to compare dose reduction efforts across institutions throughout the country will be offered.
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The time has arrived for national reimbursement of screening CT colonography.
AJR Am J Roentgenol
PUBLISHED: 06-25-2013
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CT colonography (CTC) has been fully validated as an accurate screening test for colorectal carcinoma and is being disseminated globally. There is an abundance of new literature addressing the prior concerns of the U.S. Preventive Services Task Force and the Centers for Medicare & Medicaid Services. Specific areas related to radiation dose, extracolonic findings, and generalizability of CTC to senior patients are discussed.
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Demographics and frequency of the intermittently upturned omentum at CT.
Eur J Radiol
PUBLISHED: 05-23-2013
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To describe the demographics and frequency of the intermittently upturned omentum at CT.
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Multidetector CT of the postoperative colon: review of normal appearances and common complications.
Radiographics
PUBLISHED: 03-13-2013
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If not properly recognized, the normal postoperative appearance of the pelvis following colorectal surgery can be misinterpreted as disease, including infection or recurrent tumor. However, multidetector computed tomography (CT) with the supplemental use of multiplanar reformation clearly demonstrates the expected postoperative anatomic changes in this setting. The high-resolution images achievable with multidetector CT enable the radiologist to play an important role in the postoperative assessment of patients following colon surgery. Whenever possible, the radiologist should be aware of the specific indication for the study, the type of surgery that was performed (ranging from segmental bowel excision to more extensive radical resection), and what anastomoses were created. This knowledge, as well as familiarity with the normal multidetector CT appearances of various postoperative complications, is critical for prompt diagnosis and appropriate management of these complications and for better differentiation of complications from normal findings.
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ACR appropriateness criteria jaundice.
J Am Coll Radiol
PUBLISHED: 02-15-2013
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A fundamental consideration in the workup of a jaundiced patient is the pretest probability of mechanical obstruction. Ultrasound is the first-line modality to exclude biliary tract obstruction. When mechanical obstruction is present, additional imaging with CT or MRI can clarify etiology, define level of obstruction, stage disease, and guide intervention. When mechanical obstruction is absent, additional imaging can evaluate liver parenchyma for fat and iron deposition and help direct biopsy in cases where underlying parenchymal disease or mass is found. Imaging techniques are reviewed for the following clinical scenarios: (1) the patient with painful jaundice, (2) the patient with painless jaundice, and (3) the patient with a nonmechanical cause for jaundice. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
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Advances in CT Colonography for Colorectal Cancer Screening and Diagnosis.
J Cancer
PUBLISHED: 01-15-2013
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CT colonography (CTC) is a validated colorectal cancer test that provides an additional minimally-invasive screening option which is likely to be preferred by some patients. Important examination prerequisites include adequate colonic cleansing and distention. Tagging of residual material aids in the differentiation of true polyps from stool. Low radiation dose technique should be employed routinely for screening studies. Readers must be skilled in the use of both 2D and 3D interpretation methods.
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Evidence-based Guidelines for Precision Risk Stratification-Based Screening (PRSBS) for Colorectal Cancer: Lessons learned from the US Armed Forces: Consensus and Future Directions.
J Cancer
PUBLISHED: 01-08-2013
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Colorectal cancer (CRC) is the third most common cause of cancer-related death in the United States (U.S.), with estimates of 143,460 new cases and 51,690 deaths for the year 2012. Numerous organizations have published guidelines for CRC screening; however, these numerical estimates of incidence and disease-specific mortality have remained stable from years prior. Technological, genetic profiling, molecular and surgical advances in our modern era should allow us to improve risk stratification of patients with CRC and identify those who may benefit from preventive measures, early aggressive treatment, alternative treatment strategies, and/or frequent surveillance for the early detection of disease recurrence. To better negotiate future economic constraints and enhance patient outcomes, ultimately, we propose to apply the principals of personalized and precise cancer care to risk-stratify patients for CRC screening (Precision Risk Stratification-Based Screening, PRSBS). We believe that genetic, molecular, ethnic and socioeconomic disparities impact oncological outcomes in general, those related to CRC, in particular. This document highlights evidence-based screening recommendations and risk stratification methods in response to our CRC working group private-public consensus meeting held in March 2012. Our aim was to address how we could improve CRC risk stratification-based screening, and to provide a vision for the future to achieving superior survival rates for patients diagnosed with CRC.
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Reduced cathartic bowel preparation for CT colonography: prospective comparison of 2-L polyethylene glycol and magnesium citrate.
Radiology
PUBLISHED: 08-24-2011
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To prospectively compare adequacy of colonic cleansing, adequacy of solid stool and fluid tagging, and patient acceptance by using reduced-volume, 2-L polyethylene glycol (PEG) versus magnesium citrate bowel preparations for CT colonography.
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ACR Appropriateness Criteria® right lower quadrant pain--suspected appendicitis.
J Am Coll Radiol
PUBLISHED: 07-18-2011
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The diagnostic imaging of patients presenting with right lower quadrant pain and suspected appendicitis may be organized according to age and gender and to the presence or absence of "classic" signs and symptoms of acute appendicitis. Among adult patients presenting with clinical signs of acute appendicitis, the sensitivity and specificity of CT are greater than those of ultrasound, with improved performance when CT is performed with intravenous contrast. The use of rectal contrast has been associated with decreased time in the emergency department. Computed tomography has also been shown to reduce cost and negative appendectomy rates. Both CT and ultrasound are also effective in the identification of causes of right lower quadrant pain unrelated to appendicitis. Among pediatric patients, the sensitivity and specificity of graded-compression ultrasound can approach those of CT, without the use of ionizing radiation. Performing MRI after inconclusive ultrasound in pregnant patients has been associated with sensitivity and specificity of 80% to 86% and 97% to 99%, respectively. The ACR Appropriateness Criteria(®) are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
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National CT colonography trial (ACRIN 6664): comparison of three full-laxative bowel preparations in more than 2500 average-risk patients.
AJR Am J Roentgenol
PUBLISHED: 04-23-2011
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The purpose of our study was to compare the effect of three different full-laxative bowel preparations on patient compliance, residual stool and fluid, reader confidence, and polyp detection at CT colonography (CTC).
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A prospective study on the prevalence of hydronephrosis in women with pelvic organ prolapse and their outcomes after treatment.
Int Urogynecol J
PUBLISHED: 04-14-2011
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This work aims to study the prevalence of hydronephrosis and its associated factors in women with pelvic organ prolapse (POP) and to assess the effect on hydronephrosis following treatment for POP.
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Radiation-related cancer risks from CT colonography screening: a risk-benefit analysis.
AJR Am J Roentgenol
PUBLISHED: 03-24-2011
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The purpose of this study was to estimate the ratio of cancers prevented to induced (benefit-risk ratio) for CT colonography (CTC) screening every 5 years from the age of 50 to 80 years.
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ACRIN CT colonography trial: does readers preference for primary two-dimensional versus primary three-dimensional interpretation affect performance?
Radiology
PUBLISHED: 03-01-2011
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To determine whether the readers preference for a primary two-dimensional (2D) or three-dimensional (3D) computed tomographic (CT) colonographic interpretation method affects performance when using each technique.
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Colorectal cancer screening in women: an underutilized lifesaver.
AJR Am J Roentgenol
PUBLISHED: 01-25-2011
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Colorectal cancer (CRC) represents the third most common cancer diagnosed and a major cause of cancer-related deaths in women. Despite strong evidence that early screening decreases colorectal cancer incidence and mortality rates, colorectal cancer screening rates in women still lag significantly behind screening rates for breast and cervical cancers. Additionally, women have been found to be less likely than men to undergo CRC screening. This is despite the fact that the overall lifetime risk for the development of colorectal carcinoma is similar in both sexes. Barriers to screening have been found to be different for women compared with men. Screening adherence in women also appears to be associated with various social and demographic factors.
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Persistent renal enhancement after intra-arterial versus intravenous iodixanol administration.
Eur J Radiol
PUBLISHED: 01-04-2011
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To examine the clinical significance of persistent renal enhancement after iodixanol administration.
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MR imaging evaluation of the hepatic vasculature.
Magn Reson Imaging Clin N Am
PUBLISHED: 11-25-2010
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Assessment of the hepatic vasculature is essential for tumor staging, surgical planning, and understanding of liver disease. Technological advances have made contrast-enhanced magnetic resonance (MR) imaging comparable to multidetector-row computed tomography for diagnostic vascular imaging with respect to spatial resolution. Unenhanced MR angiographic sequences enable reasonable clinical assessment of vessels without contrast agents in patients with contraindications or renal insufficiency. Furthermore, MR angiography may be used to provide directional information through manipulation of the signal intensity of flowing blood. A major limitation to consistent contrast-enhanced MR angiography is the timing of MR image acquisition with arrival of the contrast bolus in the structures of interest. In this article, the authors discuss currently available techniques for imaging of the hepatic vasculature.
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CT colonography for combined colonic and extracolonic surveillance after curative resection of colorectal cancer.
Radiology
PUBLISHED: 09-27-2010
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To determine the accuracy of contrast material-enhanced computed tomographic (CT) colonography for postoperative surveillance in colorectal cancer patients without clinical or laboratory evidence of disease recurrence.
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Can radiologist training and testing ensure high performance in CT colonography? Lessons From the National CT Colonography Trial.
AJR Am J Roentgenol
PUBLISHED: 06-23-2010
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The objective of this article is to describe the experience of the National CT Colonography Trial with radiologist training and qualification testing at CT colonography (CTC) and to correlate this experience with subsequent performance in a prospective screening study.
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Managing incidental findings on abdominal CT: white paper of the ACR incidental findings committee.
J Am Coll Radiol
PUBLISHED: 05-28-2010
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As multidetector CT has come to play a more central role in medical care and as CT image quality has improved, there has been an increase in the frequency of detecting "incidental findings," defined as findings that are unrelated to the clinical indication for the imaging examination performed. These "incidentalomas," as they are also called, often confound physicians and patients with how to manage them. Although it is known that most incidental findings are likely benign and often have little or no clinical significance, the inclination to evaluate them is often driven by physician and patient unwillingness to accept uncertainty, even given the rare possibility of an important diagnosis. The evaluation and surveillance of incidental findings have also been cited as among the causes for the increased utilization of cross-sectional imaging. Indeed, incidental findings may be serious, and hence, when and how to evaluate them are unclear. The workup of incidentalomas has varied widely by physician and region, and some standardization is desirable in light of the current need to limit costs and reduce risk to patients. Subjecting a patient with an incidentaloma to unnecessary testing and treatment can result in a potentially injurious and expensive cascade of tests and procedures. With the participation of other radiologic organizations listed herein, the ACR formed the Incidental Findings Committee to derive a practical and medically appropriate approach to managing incidental findings on CT scans of the abdomen and pelvis. The committee has used a consensus method based on repeated reviews and revisions of this document and a collective review and interpretation of relevant literature. This white paper provides guidance developed by this committee for addressing incidental findings in the kidneys, liver, adrenal glands, and pancreas.
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Extracolonic findings at CT colonography.
Gastrointest. Endosc. Clin. N. Am.
PUBLISHED: 05-11-2010
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Computed tomographic colonography (CTC) is a validated tool for the evaluation of the colon for polyps and cancer. The technique employed for CTC includes a low-dose CT scan of the abdomen and pelvis that is typically performed without the administration of intravenous contrast. Using this technique it is possible to discover findings outside of the colon. By far, most extracolonic findings are determined to be clinically inconsequential on CTC and most patients are not recommended for further testing. However, some findings may result in additional diagnostic evaluation or intervention, which can lead to patient anxiety and increased morbidity and health care costs. Alternatively, some findings can lead to the earlier diagnosis of a clinically significant lesion, which could result in decreased patient morbidity and mortality as well as overall savings in downstream health care costs. The controversies of detecting and evaluating these incidental extracolonic findings on CTC are discussed.
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CT colonography: perforation rates and potential radiation risks.
Gastrointest. Endosc. Clin. N. Am.
PUBLISHED: 05-11-2010
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Computed tomographic colonography (CTC) has emerged as an alternative screening tool for colorectal cancer due to the potential to provide good efficacy combined with greater acceptability than optical colonoscopy or fecal occult blood testing. However, some organizations have raised concerns about the potential harms, including perforation rates and radiation-related cancer risks, and have not recommended that it currently be used as a screening tool in the general population in the US. In this article the authors review the current evidence for these potential harms from CTC and compare them to the potential harms from the alternatives including colonoscopy and double-contrast barium enema.
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Muscarinic acetylcholine receptors in the nucleus accumbens core and shell contribute to cocaine priming-induced reinstatement of drug seeking.
Eur. J. Pharmacol.
PUBLISHED: 04-26-2010
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Muscarinic acetylcholine receptors in the nucleus accumbens play an important role in mediating the reinforcing effects of cocaine. However, there is a paucity of data regarding the role of accumbal muscarinic acetylcholine receptors in the reinstatement of cocaine-seeking behavior. The goal of these experiments was to assess the role of muscarinic acetylcholine receptors in the nucleus accumbens core and shell in cocaine and sucrose priming-induced reinstatement. Rats were initially trained to self-administer cocaine or sucrose on a fixed-ratio schedule of reinforcement. Lever-pressing behavior was then extinguished and followed by a subsequent reinstatement phase during which operant responding was induced by either a systemic injection of cocaine in cocaine-experienced rats or non-contingent delivery of sucrose pellets in subjects with a history of sucrose self-administration. Results indicated that systemic administration of the muscarinic acetylcholine receptor antagonist scopolamine (5.0 mg/kg, i.p.) dose-dependently attenuated cocaine, but not sucrose, reinstatement. Furthermore, administration of scopolamine (36.0 ?g) directly into the nucleus accumbens shell or core attenuated cocaine priming-induced reinstatement. In contrast, infusion of scopolamine (36.0 ?g) directly into the accumbens core, but not shell, attenuated sucrose reinstatement, which suggests that muscarinic acetylcholine receptors in these two subregions of the nucleus accumbens have differential roles in sucrose seeking. Taken together, these results indicate that cocaine priming-induced reinstatement is mediated, in part, by increased signaling through muscarinic acetylcholine receptors in the shell subregion of the nucleus accumbens. Muscarinic acetylcholine receptors in the core of the accumbens, in contrast, appear to play a more general (i.e. not cocaine specific) role in motivated behaviors.
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ACR Appropriateness Criteria on colorectal cancer screening.
J Am Coll Radiol
PUBLISHED: 04-26-2010
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Colorectal cancer remains one of the most common causes of cancer death in this country. This malignancy is ideally suited for screening because the detection and removal of the precursor adenomatous polyp can prevent most colorectal cancers from ever forming. The choice of a test for screening involves consideration of various individual parameters, including patient age and the presence of risk factors for the development of colorectal cancer. Computed tomographic colonography (CTC) has emerged as the leading imaging technique for colorectal cancer screening in average-risk individuals on the basis of the evidence presented in this paper. The double-contrast barium enema is an alternative imaging test that is appropriate particularly when CTC is not available. In 2008, the American Cancer Society guideline for colorectal cancer screening was revised jointly with the US Multi-Society Task Force on Colorectal Cancer and the ACR to include CTC every 5 years as an option for average-risk individuals. Computed tomographic colonography is also the preferred test for colon evaluation after an incomplete colonoscopy. Imaging tests including CTC and the double-contrast barium enema are usually not indicated for colorectal cancer screening in high-risk patients with polyposis syndromes or inflammatory bowel disease. This paper presents the new colorectal cancer imaging test ratings and is the result of evidence-based consensus by the ACR Appropriateness Criteria Expert Panel on Gastrointestinal Imaging.
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Current status of MR colonography.
Radiographics
PUBLISHED: 01-20-2010
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The search for an acceptable colorectal cancer screening examination has led to the development of virtual colonoscopy, which includes both computed tomographic (CT) colonography and magnetic resonance (MR) colonography. As indicated by the much larger number of published studies on CT colonography than on MR colonography, multidetector CT appears to be more suitable for colorectal screening than does MR colonography, in part reflecting the ease and speed of performing CT, as well as the increased spatial resolution, decreased cost, and wider availability of CT colonography. The main advantage of MR colonography over CT colonography is that it does not use ionizing radiation, which has important implications for colorectal cancer screening. The use of dark-lumen MR colonography to screen patients for colorectal cancer as well as other abdominopelvic disease could make it more attractive than CT. With the integration of 3.0-T MR colonography, fecal tagging, and parallel imaging into research and clinical settings, new MR colonography protocols must be optimized. Future MR colonography research should address issues such as image characteristics, presence of artifacts, management of specific absorption rate, and hardware-related modifications.
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ACR Colon Cancer Committee white paper: status of CT colonography 2009.
J Am Coll Radiol
PUBLISHED: 08-25-2009
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To review the current status and rationale of the updated ACR practice guidelines for CT colonography (CTC).
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Delayed enhancement of ascites after i.v. contrast material administration at CT: time course and clinical correlation.
AJR Am J Roentgenol
PUBLISHED: 08-22-2009
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The objective of our study was to determine the prevalence and clinical predictors of delayed contrast enhancement of ascites.
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Symptomatic ostial vertebral artery stenosis: treatment with drug-eluting stents--clinical and angiographic results at 1-year follow-up.
Radiology
PUBLISHED: 04-01-2009
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To evaluate the feasibility and preliminary results of using paclitaxel-eluting stents for angioplasty and to treat symptomatic atherosclerotic ostial vertebral artery (VA) stenosis.
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The use of average Pavlov ratio to predict the risk of post operative upper limb palsy after posterior cervical decompression.
J Orthop Surg Res
PUBLISHED: 03-19-2009
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A retrospective study was conducted to study the post operative upper limb palsy after laminoplasty for cervical myelopathy.
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CT colonography: techniques and applications.
Radiol. Clin. North Am.
PUBLISHED: 02-07-2009
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CT colonography (CTC), also termed virtual colonoscopy, is increasingly accepted at sites throughout the world as a new effective tool for the diagnosis and screening of colorectal carcinoma. This article presents information of related issues of bowel cleansing, stool and fluid tagging, bowel distention and multidetector CT scanning parameters. The author presents discussion of interpretation of CTC, appropriate applications of CTC and potential complications.
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Metabotropic glutamate receptor 5 (mGluR5) antagonists attenuate cocaine priming- and cue-induced reinstatement of cocaine seeking.
Behav. Brain Res.
PUBLISHED: 01-07-2009
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Accumulating evidence suggests that metabotropic glutamate receptors (mGluRs) are involved in both cocaine reinforcement and the reinstatement of cocaine-seeking behavior. In the present experiments, rats were trained to self-administer cocaine under fixed ratio (for cocaine priming-induced reinstatement) or second-order (for cocaine cue-induced reinstatement) schedules of reinforcement. Lever pressing was then extinguished followed by a reinstatement phase where operant responding was promoted by either cocaine itself or cocaine-associated light cues. Results indicated that systemic administration of the mGluR5 antagonists 2-methyl-6-(phenylethynyl)pyridine (MPEP: 1 and 3mg/kg i.p.) or 3-((2-methyl-1,3-thiazol-4-yl)ethynyl)pyridine (MTEP: 0.1 and 1mg/kg i.p.) dose-dependently attenuated reinstatement of drug seeking induced by a systemic priming injection of 10mg/kg cocaine. Systemic administration of MTEP (0.1 and 1mg/kg i.p.) also dose-dependently attenuated cocaine cue-induced reinstatement of drug seeking. Systemic administration of neither MPEP nor MTEP influenced the reinstatement of sucrose seeking, which indicates that the effects of these compounds on cocaine seeking were reinforcer specific. Additionally, administration of MPEP (1microg/0.5microl) into the nucleus accumbens shell, a brain region that plays a critical role in cocaine seeking, attenuated cocaine priming-induced reinstatement of drug seeking. These results add to a growing literature indicating that mGluR antagonists attenuate the reinstatement of cocaine seeking. Importantly, the current findings also suggest that activation of mGluR5s specifically in the nucleus accumbens shell may promote the reinstatement of cocaine seeking.
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ACR Appropriateness Criteria pretreatment staging of colorectal cancer.
J Am Coll Radiol
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Because virtually all patients with colonic cancer will undergo some form of surgical therapy, the role of preoperative imaging is directed at determining the presence or absence of synchronous carcinomas or adenomas and local or distant metastases. In contrast, preoperative staging for rectal carcinoma has significant therapeutic implications and will direct the use of radiation therapy, surgical excision, or chemotherapy. CT of the chest, abdomen, and pelvis is recommended for the initial evaluation for the preoperative assessment of patients with colorectal carcinoma. Although the overall accuracy of CT varies directly with the stage of colorectal carcinoma, CT can accurately assess the presence of metastatic disease. MRI using endorectal coils can accurately assess the depth of bowel wall penetration of rectal carcinomas. Phased-array coils provide additional information about lymph node involvement. Adding diffusion-weighted imaging to conventional MRI yields better diagnostic accuracy than conventional MRI alone. Transrectal ultrasound can distinguish layers within the rectal wall and provides accurate assessment of the depth of tumor penetration and perirectal spread, and PET and PET/CT have been shown to alter therapy in almost one-third of patients with advanced primary rectal cancer. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
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The National CT Colonography Trial: assessment of accuracy in participants 65 years of age and older.
Radiology
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To conduct post-hoc analysis of National CT Colonography Trial data and compare the sensitivity and specificity of computed tomographic (CT) colonography in participants younger than 65 years with those in participants aged 65 years and older.
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Esophageal varices on computed tomography and subsequent variceal hemorrhage.
Abdom Imaging
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Endoscopy is recommended to screen for esophageal varices in patients with cirrhosis. The objective of this study was to identify features on abdominal CT imaging associated variceal hemorrhage (VH).
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.