The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Luc A Heijnen - One of the best experts on this subject based on the ideXlab platform.
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Value of Gadofosveset-enhanced MRI and multiplanar reformatting for selecting good responders after chemoradiation for rectal cancer.
2014Co-Authors: Luc A Heijnen, Doenja M J Lambregts, Monique Maas, Milou H Martens, Robert G Riedl, Geerard L Beets, M. J. Lahaye, Ulrich Lalji, Regina G. H. Beets-tanAbstract:Objectives Our primary objective was to evaluate diagnostic performance of Gadofosveset T1-weighted magnetic resonance imaging (T1W MRI) for discriminating between ypT0–2 and ypT3–4 tumours after chemoradiation therapy (CRT) for rectal cancer compared with T2W MRI for a general and expert reader. Second objectives included assessing the value of multiplanar reformatting (MPR) and interobserver agreement.
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value of Gadofosveset enhanced mri and multiplanar reformatting for selecting good responders after chemoradiation for rectal cancer
2014Co-Authors: Luc A Heijnen, Doenja M J Lambregts, Monique Maas, Milou H Martens, Robert G Riedl, Geerard L Beets, Max J. Lahaye, Ulrich Lalji, Regina G H BeetstanAbstract:Our primary objective was to evaluate diagnostic performance of Gadofosveset T1-weighted magnetic resonance imaging (T1W MRI) for discriminating between ypT0–2 and ypT3–4 tumours after chemoradiation therapy (CRT) for rectal cancer compared with T2W MRI for a general and expert reader. Second objectives included assessing the value of multiplanar reformatting (MPR) and interobserver agreement. A general and expert reader evaluated 49 patients for likelihood of ypT0–2 tumour after CRT on T2W, Gadofosveset T1W MRI, and Gadofosveset T1W MRI + T2W MRI. The general reader scored with and without MPR. Confidence level scores were used to construct receiver-operating characteristic (ROC) curves. Area under the curve (AUC) values and diagnostic parameters were calculated and compared. Gadofosveset T1W MRI + T2W MRI showed slightly superior sensitivity than T2W MRI for the general but not the expert reader. Specificity was higher for the expert on Gadofosveset T1W MRI only compared with T2W MRI only (100 % vs. 82 %). MPR did not increase diagnostic performance. Interobserver agreement was highest for the combination of Gadofosveset-enhanced T1W imaging plus T2W MRI. The sole use or addition of Gadofosveset-enhanced T1W MRI to T2W MRI did not increase significantly diagnostic performance for assessing ypT0–2 tumours. Adding Gadofosveset-enhanced T1W MRI slightly increased sensitivity for the general reader and specificity for the expert reader, but this increase was not significant for more accurate clinical decision making. MPR did not improve diagnostic performance. • ycT restaging with MRI in rectal cancer is challenging. • Gadofosveset-enhanced T1W MRI has shown promise for nodal restaging. • Gadofosveset-enhanced T1W MRI did not significantly increase diagnostic performance for assessing ypT0–2-tumours. • Addition of the Gadofosveset sequence to T2W MRI slightly increased sensitivity for the general reader. • MPR did not improve diagnostic performance of ycT staging.
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performance of Gadofosveset enhanced mri for staging rectal cancer nodes can the initial promising results be reproduced
2014Co-Authors: Doenja M J Lambregts, Luc A Heijnen, Monique Maas, Milou H Martens, Frans C H Bakers, Vincent C Cappendijk, Pedro C Oliveira, Guido LammeringAbstract:A previous study showed promising results for Gadofosveset-trisodium as a lymph node magnetic resonance imaging (MRI) contrast agent in rectal cancer. The aim of this study was to prospectively confirm the diagnostic performance of Gadofosveset MRI for nodal (re)staging in rectal cancer in a second patient cohort. Seventy-one rectal cancer patients were prospectively included, of whom 13 (group I) underwent a primary staging Gadofosveset MRI (1.5-T) followed by surgery (± preoperative 5 × 5 Gy) and 58 (group II) underwent both primary staging and restaging Gadofosveset MRI after a long course of chemoradiotherapy followed by surgery. Nodal status was scored as (y)cN0 or (y)cN+ by two independent readers (R1, R2) with different experience levels. Results were correlated with histology on a node-by-node basis. Sensitivity, specificity and area under the receiver operating characteristics curve (AUC) were 94 %, 79 % and 0.89 for the more experienced R1 and 50 %, 83 % and 0.74 for the non-experienced R2. R2’s performance improved considerably after a learning curve, to an AUC of 0.83. Misinterpretations mainly occurred in nodes located in the superior mesorectum, nodes located in between vessels and nodes containing micrometastases. This prospective study confirms the good diagnostic performance of Gadofosveset MRI for nodal (re)staging in rectal cancer. • Gadofosveset-enhanced MRI shows high performance for nodal (re)staging in rectal cancer. • Gadofosveset MRI may facilitate better selection of patients for personalised treatment. • Results can be reproduced by non-expert readers. • Experience of 50–60 cases is required to achieve required expertise level. • Main pitfalls are nodes located between vessels and nodes containing micrometastases.
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Performance of Gadofosveset-enhanced MRI for staging rectal cancer nodes: can the initial promising results be reproduced?
2013Co-Authors: Luc A Heijnen, Doenja M J Lambregts, Monique Maas, Milou H Martens, Robert G Riedl, Frans C H Bakers, Vincent C Cappendijk, Pedro Oliveira, Guido Lammering, Geerard L BeetsAbstract:Objectives A previous study showed promising results for Gadofosveset-trisodium as a lymph node magnetic resonance imaging (MRI) contrast agent in rectal cancer. The aim of this study was to prospectively confirm the diagnostic performance of Gadofosveset MRI for nodal (re)staging in rectal cancer in a second patient cohort.
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Gadofosveset enhanced mri for the assessment of rectal cancer lymph nodes predictive criteria
2013Co-Authors: Doenja M J Lambregts, Luc A Heijnen, Monique Maas, Iris J G Rutten, Milou H Martens, Walter H Backes, Robert G Riedl, Frans C H Bakers, Vincent C Cappendijk, Geerard L BeetsAbstract:To confirm the use of the nodal signal intensity (SI) and the ‘chemical shift’ artefact as diagnostic criteria for detecting nodal metastases from rectal cancer on Gadofosveset contrast-enhanced MRI. Thirty-three patients underwent a non-enhanced and Gadofosveset-enhanced 3D-T1W GRE-MRI at 1.5T. For each lymph node, the SI of the middle part of the node (mSI) and white rim of the chemical shift artefact encircling the node (wSI) were measured on the non-enhanced and Gadofosveset-enhanced images. Second, the aspect of the chemical shift artefact encircling the nodes was scored using a 4-point scale. Results were compared with histology on a node-by-node basis. 289 nodes (55 N+) were analysed. On Gadofosveset-MRI, mSI and wSI were significantly higher for the benign than for the metastatic lymph nodes (p < 0.001). Areas under the ROC curve (AUC) for identification of metastases were 0.74 (mSI) and 0.73 (wSI). The chemical shift criterion rendered an AUC of 0.85. The combination of mSI and the chemical shift criterion resulted in an AUC of 0.88 and the rendered an AUC of 0.86–0.92 when subjectively (visually) assessed by two independent readers. Benign lymph nodes show significant contrast enhancement after Gadofosveset injection, while metastatic nodes do not. The uptake of Gadofosveset in the nodes also affects the chemical shift artefact encircling the nodes. Combined assessment of these two features on Gadofosveset-enhanced MRI provides a high diagnostic performance for diagnosing metastatic lymph nodes in patients with rectal cancer.
Deniz Bilecen - One of the best experts on this subject based on the ideXlab platform.
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Gadofosveset--a blood pool contrast agent used with MRI to detect obscure gastrointestinal bleeding: a case report.
2012Co-Authors: Bjoern Jacobi, Lisa Zipp, Sasan Partovi, Tilman Schubert, Matthias Loebe, Alan B. Lumsden, Michele Pansini, Deniz BilecenAbstract:Gadofosveset—A Blood Pool Contrast Agent Used with MRI to Detect Obscure Gastrointestinal Bleeding: A Case Report
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Gadofosveset enhanced mr phlebography for detecting pelvic and deep vein leg thrombosis
2011Co-Authors: Sasan Partovi, Markus Aschwanden, Matthias Rasmus, Lisa Zipp, Bjoern Jacobi, Daniel Staub, Rolf Hügli, Fabian Rengier, Deniz BilecenAbstract:Background: Deep venous thrombosis is mainly diagnosed by ultrasound today. In some instances diagnosis is challenging and magnetic resonance angiography could be an attractive alternative. Gadofosveset is a blood pool contrast agent with some favourable properties for this purpose. Patients and methods: We investigated eight patients with proven deep venous thrombosis by Gadofosveset enhanced MR phlebography. We performed a 3D gradient-echo sequence with an overall measurement time of 9 minutes and 6 seconds. One minute after injection of Gadofosveset in a concentration of 0.12 ml/kg body weight images were acquired. Thrombi were visualised by their lack of luminal contrast filling. Results: Thrombi were visualised in all patients. In one patient with extended thrombosis a previously undiagnosed ovarian adenocarcinoma was detected additionally. Conclusions: Deep venous thromboses in lower extremities can be visualised reliably by performing MR phlebography with blood pool contrast agent Gadofosveset. Vis...
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Gadobenate Dimeglumine and Gadofosveset Trisodium for MR Angiography of the Renal Arteries: Multicenter Intraindividual Crossover Comparison
2010Co-Authors: Guenther Schneider, Deniz Bilecen, Josef Vymazal, Roberto Iezzi, Mieczyslaw Pasowicz, Zdenek Seidl, Manuela Aschauer, Marek Konopka, Claudio BallaratiAbstract:OBJECTIVE. This prospective multicenter intraindividual crossover study was designed to compare gadobenate dimeglumine and Gadofosveset trisodium at approved doses with respect to the image quality and diagnostic performance of contrast-enhanced MR angiography (CE-MRA) in the detection of clinically relevant renal artery stenosis.SUBJECTS AND METHODS. Thirty-nine subjects (17 men, 22 women; age range, 30–86 years; mean 62 ± 13.3 [SD] years) with known or suspected renovascular disease underwent a first CE-MRA examination with 0.1 mmol/kg gadobenate dimeglumine and a second examination 3–12 days later with 0.03 mmol/kg Gadofosveset. Identical T1-weighted spoiled gradient-refocused echo coronal first-pass images were acquired for 38 of the 39 patients. For 15 of the 38 patients, additional sagittal or axial images or both were acquired with Gadofosveset during the steady-state phase. Thirty-four patients underwent digital subtraction angiography, which was the reference standard. Three independent blinded r...
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Dynamic magnetic resonance angiography of the arteries of the hand. A comparison between an extracellular and an intravascular contrast agent.
2008Co-Authors: Clemens Reisinger, Thomas M. Gluecker, Augustinus Ludwig Jacob, Georg Bongartz, Deniz BilecenAbstract:The purpose of this study was to compare the image quality of the intravascular contrast agent Gadofosveset with the extracellular contrast agent gadoterate meglumine in time-resolved three-dimensional magnetic resonance (MR) angiography of the human arteries of the hand. The value of cuff compression technique for suppression of venous enhancement for both contrast agents was also investigated. Three-dimensional MR angiograms of both hands of 11 healthy volunteers were acquired for each contrast agent at 1.5-T, while subsystolic cuff compression was applied at one side. Quantitative and qualitative evaluation were performed and analyzed with Student’s t-test. Visualization of vessels was superior in the images acquired with Gadofosveset, especially in the late phases. Quantitative and qualitative evaluation showed significantly higher values for Gadofosveset. The cuff compression at the lower arm proved to be an effective method to enhance arterial vessels. In conclusion the blood pool agent Gadofosveset is superior for the dynamic imaging of the vessels of the hand when compared with the extracellular contrast agent gadoterate meglumine. To fully utilize the advantages of intravascular contrast agents, venous overlay has to be delayed or reduced, which can be achieved effectively by subsystolic lower arm cuff compression.
Geerard L Beets - One of the best experts on this subject based on the ideXlab platform.
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Value of Gadofosveset-enhanced MRI and multiplanar reformatting for selecting good responders after chemoradiation for rectal cancer.
2014Co-Authors: Luc A Heijnen, Doenja M J Lambregts, Monique Maas, Milou H Martens, Robert G Riedl, Geerard L Beets, M. J. Lahaye, Ulrich Lalji, Regina G. H. Beets-tanAbstract:Objectives Our primary objective was to evaluate diagnostic performance of Gadofosveset T1-weighted magnetic resonance imaging (T1W MRI) for discriminating between ypT0–2 and ypT3–4 tumours after chemoradiation therapy (CRT) for rectal cancer compared with T2W MRI for a general and expert reader. Second objectives included assessing the value of multiplanar reformatting (MPR) and interobserver agreement.
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value of Gadofosveset enhanced mri and multiplanar reformatting for selecting good responders after chemoradiation for rectal cancer
2014Co-Authors: Luc A Heijnen, Doenja M J Lambregts, Monique Maas, Milou H Martens, Robert G Riedl, Geerard L Beets, Max J. Lahaye, Ulrich Lalji, Regina G H BeetstanAbstract:Our primary objective was to evaluate diagnostic performance of Gadofosveset T1-weighted magnetic resonance imaging (T1W MRI) for discriminating between ypT0–2 and ypT3–4 tumours after chemoradiation therapy (CRT) for rectal cancer compared with T2W MRI for a general and expert reader. Second objectives included assessing the value of multiplanar reformatting (MPR) and interobserver agreement. A general and expert reader evaluated 49 patients for likelihood of ypT0–2 tumour after CRT on T2W, Gadofosveset T1W MRI, and Gadofosveset T1W MRI + T2W MRI. The general reader scored with and without MPR. Confidence level scores were used to construct receiver-operating characteristic (ROC) curves. Area under the curve (AUC) values and diagnostic parameters were calculated and compared. Gadofosveset T1W MRI + T2W MRI showed slightly superior sensitivity than T2W MRI for the general but not the expert reader. Specificity was higher for the expert on Gadofosveset T1W MRI only compared with T2W MRI only (100 % vs. 82 %). MPR did not increase diagnostic performance. Interobserver agreement was highest for the combination of Gadofosveset-enhanced T1W imaging plus T2W MRI. The sole use or addition of Gadofosveset-enhanced T1W MRI to T2W MRI did not increase significantly diagnostic performance for assessing ypT0–2 tumours. Adding Gadofosveset-enhanced T1W MRI slightly increased sensitivity for the general reader and specificity for the expert reader, but this increase was not significant for more accurate clinical decision making. MPR did not improve diagnostic performance. • ycT restaging with MRI in rectal cancer is challenging. • Gadofosveset-enhanced T1W MRI has shown promise for nodal restaging. • Gadofosveset-enhanced T1W MRI did not significantly increase diagnostic performance for assessing ypT0–2-tumours. • Addition of the Gadofosveset sequence to T2W MRI slightly increased sensitivity for the general reader. • MPR did not improve diagnostic performance of ycT staging.
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Performance of Gadofosveset-enhanced MRI for staging rectal cancer nodes: can the initial promising results be reproduced?
2013Co-Authors: Luc A Heijnen, Doenja M J Lambregts, Monique Maas, Milou H Martens, Robert G Riedl, Frans C H Bakers, Vincent C Cappendijk, Pedro Oliveira, Guido Lammering, Geerard L BeetsAbstract:Objectives A previous study showed promising results for Gadofosveset-trisodium as a lymph node magnetic resonance imaging (MRI) contrast agent in rectal cancer. The aim of this study was to prospectively confirm the diagnostic performance of Gadofosveset MRI for nodal (re)staging in rectal cancer in a second patient cohort.
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Gadofosveset enhanced mri for the assessment of rectal cancer lymph nodes predictive criteria
2013Co-Authors: Doenja M J Lambregts, Luc A Heijnen, Monique Maas, Iris J G Rutten, Milou H Martens, Walter H Backes, Robert G Riedl, Frans C H Bakers, Vincent C Cappendijk, Geerard L BeetsAbstract:To confirm the use of the nodal signal intensity (SI) and the ‘chemical shift’ artefact as diagnostic criteria for detecting nodal metastases from rectal cancer on Gadofosveset contrast-enhanced MRI. Thirty-three patients underwent a non-enhanced and Gadofosveset-enhanced 3D-T1W GRE-MRI at 1.5T. For each lymph node, the SI of the middle part of the node (mSI) and white rim of the chemical shift artefact encircling the node (wSI) were measured on the non-enhanced and Gadofosveset-enhanced images. Second, the aspect of the chemical shift artefact encircling the nodes was scored using a 4-point scale. Results were compared with histology on a node-by-node basis. 289 nodes (55 N+) were analysed. On Gadofosveset-MRI, mSI and wSI were significantly higher for the benign than for the metastatic lymph nodes (p < 0.001). Areas under the ROC curve (AUC) for identification of metastases were 0.74 (mSI) and 0.73 (wSI). The chemical shift criterion rendered an AUC of 0.85. The combination of mSI and the chemical shift criterion resulted in an AUC of 0.88 and the rendered an AUC of 0.86–0.92 when subjectively (visually) assessed by two independent readers. Benign lymph nodes show significant contrast enhancement after Gadofosveset injection, while metastatic nodes do not. The uptake of Gadofosveset in the nodes also affects the chemical shift artefact encircling the nodes. Combined assessment of these two features on Gadofosveset-enhanced MRI provides a high diagnostic performance for diagnosing metastatic lymph nodes in patients with rectal cancer.
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Accuracy of Gadofosveset-enhanced MRI for Nodal Staging and Restaging in Rectal Cancer
2011Co-Authors: Doenja M J Lambregts, Monique Maas, Frans C H Bakers, Vincent C Cappendijk, Geerard L Beets, Alfons G.h. Kessels, Sanne M. E. Engelen, Max J. Lahaye, Adriaan P. De Bruïne, Guido LammeringAbstract:Objective:To prospectively assess the accuracy of Gadofosveset-enhanced magnetic resonance imaging (MRI) for nodal staging and restaging in rectal cancer.Background:Accurate preoperative assessment of nodal disease in rectal cancer impacts treatment management. Staging with modern imaging techniques
Doenja M J Lambregts - One of the best experts on this subject based on the ideXlab platform.
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Value of Gadofosveset-enhanced MRI and multiplanar reformatting for selecting good responders after chemoradiation for rectal cancer.
2014Co-Authors: Luc A Heijnen, Doenja M J Lambregts, Monique Maas, Milou H Martens, Robert G Riedl, Geerard L Beets, M. J. Lahaye, Ulrich Lalji, Regina G. H. Beets-tanAbstract:Objectives Our primary objective was to evaluate diagnostic performance of Gadofosveset T1-weighted magnetic resonance imaging (T1W MRI) for discriminating between ypT0–2 and ypT3–4 tumours after chemoradiation therapy (CRT) for rectal cancer compared with T2W MRI for a general and expert reader. Second objectives included assessing the value of multiplanar reformatting (MPR) and interobserver agreement.
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value of Gadofosveset enhanced mri and multiplanar reformatting for selecting good responders after chemoradiation for rectal cancer
2014Co-Authors: Luc A Heijnen, Doenja M J Lambregts, Monique Maas, Milou H Martens, Robert G Riedl, Geerard L Beets, Max J. Lahaye, Ulrich Lalji, Regina G H BeetstanAbstract:Our primary objective was to evaluate diagnostic performance of Gadofosveset T1-weighted magnetic resonance imaging (T1W MRI) for discriminating between ypT0–2 and ypT3–4 tumours after chemoradiation therapy (CRT) for rectal cancer compared with T2W MRI for a general and expert reader. Second objectives included assessing the value of multiplanar reformatting (MPR) and interobserver agreement. A general and expert reader evaluated 49 patients for likelihood of ypT0–2 tumour after CRT on T2W, Gadofosveset T1W MRI, and Gadofosveset T1W MRI + T2W MRI. The general reader scored with and without MPR. Confidence level scores were used to construct receiver-operating characteristic (ROC) curves. Area under the curve (AUC) values and diagnostic parameters were calculated and compared. Gadofosveset T1W MRI + T2W MRI showed slightly superior sensitivity than T2W MRI for the general but not the expert reader. Specificity was higher for the expert on Gadofosveset T1W MRI only compared with T2W MRI only (100 % vs. 82 %). MPR did not increase diagnostic performance. Interobserver agreement was highest for the combination of Gadofosveset-enhanced T1W imaging plus T2W MRI. The sole use or addition of Gadofosveset-enhanced T1W MRI to T2W MRI did not increase significantly diagnostic performance for assessing ypT0–2 tumours. Adding Gadofosveset-enhanced T1W MRI slightly increased sensitivity for the general reader and specificity for the expert reader, but this increase was not significant for more accurate clinical decision making. MPR did not improve diagnostic performance. • ycT restaging with MRI in rectal cancer is challenging. • Gadofosveset-enhanced T1W MRI has shown promise for nodal restaging. • Gadofosveset-enhanced T1W MRI did not significantly increase diagnostic performance for assessing ypT0–2-tumours. • Addition of the Gadofosveset sequence to T2W MRI slightly increased sensitivity for the general reader. • MPR did not improve diagnostic performance of ycT staging.
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performance of Gadofosveset enhanced mri for staging rectal cancer nodes can the initial promising results be reproduced
2014Co-Authors: Doenja M J Lambregts, Luc A Heijnen, Monique Maas, Milou H Martens, Frans C H Bakers, Vincent C Cappendijk, Pedro C Oliveira, Guido LammeringAbstract:A previous study showed promising results for Gadofosveset-trisodium as a lymph node magnetic resonance imaging (MRI) contrast agent in rectal cancer. The aim of this study was to prospectively confirm the diagnostic performance of Gadofosveset MRI for nodal (re)staging in rectal cancer in a second patient cohort. Seventy-one rectal cancer patients were prospectively included, of whom 13 (group I) underwent a primary staging Gadofosveset MRI (1.5-T) followed by surgery (± preoperative 5 × 5 Gy) and 58 (group II) underwent both primary staging and restaging Gadofosveset MRI after a long course of chemoradiotherapy followed by surgery. Nodal status was scored as (y)cN0 or (y)cN+ by two independent readers (R1, R2) with different experience levels. Results were correlated with histology on a node-by-node basis. Sensitivity, specificity and area under the receiver operating characteristics curve (AUC) were 94 %, 79 % and 0.89 for the more experienced R1 and 50 %, 83 % and 0.74 for the non-experienced R2. R2’s performance improved considerably after a learning curve, to an AUC of 0.83. Misinterpretations mainly occurred in nodes located in the superior mesorectum, nodes located in between vessels and nodes containing micrometastases. This prospective study confirms the good diagnostic performance of Gadofosveset MRI for nodal (re)staging in rectal cancer. • Gadofosveset-enhanced MRI shows high performance for nodal (re)staging in rectal cancer. • Gadofosveset MRI may facilitate better selection of patients for personalised treatment. • Results can be reproduced by non-expert readers. • Experience of 50–60 cases is required to achieve required expertise level. • Main pitfalls are nodes located between vessels and nodes containing micrometastases.
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Performance of Gadofosveset-enhanced MRI for staging rectal cancer nodes: can the initial promising results be reproduced?
2013Co-Authors: Luc A Heijnen, Doenja M J Lambregts, Monique Maas, Milou H Martens, Robert G Riedl, Frans C H Bakers, Vincent C Cappendijk, Pedro Oliveira, Guido Lammering, Geerard L BeetsAbstract:Objectives A previous study showed promising results for Gadofosveset-trisodium as a lymph node magnetic resonance imaging (MRI) contrast agent in rectal cancer. The aim of this study was to prospectively confirm the diagnostic performance of Gadofosveset MRI for nodal (re)staging in rectal cancer in a second patient cohort.
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Gadofosveset enhanced mri for the assessment of rectal cancer lymph nodes predictive criteria
2013Co-Authors: Doenja M J Lambregts, Luc A Heijnen, Monique Maas, Iris J G Rutten, Milou H Martens, Walter H Backes, Robert G Riedl, Frans C H Bakers, Vincent C Cappendijk, Geerard L BeetsAbstract:To confirm the use of the nodal signal intensity (SI) and the ‘chemical shift’ artefact as diagnostic criteria for detecting nodal metastases from rectal cancer on Gadofosveset contrast-enhanced MRI. Thirty-three patients underwent a non-enhanced and Gadofosveset-enhanced 3D-T1W GRE-MRI at 1.5T. For each lymph node, the SI of the middle part of the node (mSI) and white rim of the chemical shift artefact encircling the node (wSI) were measured on the non-enhanced and Gadofosveset-enhanced images. Second, the aspect of the chemical shift artefact encircling the nodes was scored using a 4-point scale. Results were compared with histology on a node-by-node basis. 289 nodes (55 N+) were analysed. On Gadofosveset-MRI, mSI and wSI were significantly higher for the benign than for the metastatic lymph nodes (p < 0.001). Areas under the ROC curve (AUC) for identification of metastases were 0.74 (mSI) and 0.73 (wSI). The chemical shift criterion rendered an AUC of 0.85. The combination of mSI and the chemical shift criterion resulted in an AUC of 0.88 and the rendered an AUC of 0.86–0.92 when subjectively (visually) assessed by two independent readers. Benign lymph nodes show significant contrast enhancement after Gadofosveset injection, while metastatic nodes do not. The uptake of Gadofosveset in the nodes also affects the chemical shift artefact encircling the nodes. Combined assessment of these two features on Gadofosveset-enhanced MRI provides a high diagnostic performance for diagnosing metastatic lymph nodes in patients with rectal cancer.
Milou H Martens - One of the best experts on this subject based on the ideXlab platform.
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Value of Gadofosveset-enhanced MRI and multiplanar reformatting for selecting good responders after chemoradiation for rectal cancer.
2014Co-Authors: Luc A Heijnen, Doenja M J Lambregts, Monique Maas, Milou H Martens, Robert G Riedl, Geerard L Beets, M. J. Lahaye, Ulrich Lalji, Regina G. H. Beets-tanAbstract:Objectives Our primary objective was to evaluate diagnostic performance of Gadofosveset T1-weighted magnetic resonance imaging (T1W MRI) for discriminating between ypT0–2 and ypT3–4 tumours after chemoradiation therapy (CRT) for rectal cancer compared with T2W MRI for a general and expert reader. Second objectives included assessing the value of multiplanar reformatting (MPR) and interobserver agreement.
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value of Gadofosveset enhanced mri and multiplanar reformatting for selecting good responders after chemoradiation for rectal cancer
2014Co-Authors: Luc A Heijnen, Doenja M J Lambregts, Monique Maas, Milou H Martens, Robert G Riedl, Geerard L Beets, Max J. Lahaye, Ulrich Lalji, Regina G H BeetstanAbstract:Our primary objective was to evaluate diagnostic performance of Gadofosveset T1-weighted magnetic resonance imaging (T1W MRI) for discriminating between ypT0–2 and ypT3–4 tumours after chemoradiation therapy (CRT) for rectal cancer compared with T2W MRI for a general and expert reader. Second objectives included assessing the value of multiplanar reformatting (MPR) and interobserver agreement. A general and expert reader evaluated 49 patients for likelihood of ypT0–2 tumour after CRT on T2W, Gadofosveset T1W MRI, and Gadofosveset T1W MRI + T2W MRI. The general reader scored with and without MPR. Confidence level scores were used to construct receiver-operating characteristic (ROC) curves. Area under the curve (AUC) values and diagnostic parameters were calculated and compared. Gadofosveset T1W MRI + T2W MRI showed slightly superior sensitivity than T2W MRI for the general but not the expert reader. Specificity was higher for the expert on Gadofosveset T1W MRI only compared with T2W MRI only (100 % vs. 82 %). MPR did not increase diagnostic performance. Interobserver agreement was highest for the combination of Gadofosveset-enhanced T1W imaging plus T2W MRI. The sole use or addition of Gadofosveset-enhanced T1W MRI to T2W MRI did not increase significantly diagnostic performance for assessing ypT0–2 tumours. Adding Gadofosveset-enhanced T1W MRI slightly increased sensitivity for the general reader and specificity for the expert reader, but this increase was not significant for more accurate clinical decision making. MPR did not improve diagnostic performance. • ycT restaging with MRI in rectal cancer is challenging. • Gadofosveset-enhanced T1W MRI has shown promise for nodal restaging. • Gadofosveset-enhanced T1W MRI did not significantly increase diagnostic performance for assessing ypT0–2-tumours. • Addition of the Gadofosveset sequence to T2W MRI slightly increased sensitivity for the general reader. • MPR did not improve diagnostic performance of ycT staging.
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performance of Gadofosveset enhanced mri for staging rectal cancer nodes can the initial promising results be reproduced
2014Co-Authors: Doenja M J Lambregts, Luc A Heijnen, Monique Maas, Milou H Martens, Frans C H Bakers, Vincent C Cappendijk, Pedro C Oliveira, Guido LammeringAbstract:A previous study showed promising results for Gadofosveset-trisodium as a lymph node magnetic resonance imaging (MRI) contrast agent in rectal cancer. The aim of this study was to prospectively confirm the diagnostic performance of Gadofosveset MRI for nodal (re)staging in rectal cancer in a second patient cohort. Seventy-one rectal cancer patients were prospectively included, of whom 13 (group I) underwent a primary staging Gadofosveset MRI (1.5-T) followed by surgery (± preoperative 5 × 5 Gy) and 58 (group II) underwent both primary staging and restaging Gadofosveset MRI after a long course of chemoradiotherapy followed by surgery. Nodal status was scored as (y)cN0 or (y)cN+ by two independent readers (R1, R2) with different experience levels. Results were correlated with histology on a node-by-node basis. Sensitivity, specificity and area under the receiver operating characteristics curve (AUC) were 94 %, 79 % and 0.89 for the more experienced R1 and 50 %, 83 % and 0.74 for the non-experienced R2. R2’s performance improved considerably after a learning curve, to an AUC of 0.83. Misinterpretations mainly occurred in nodes located in the superior mesorectum, nodes located in between vessels and nodes containing micrometastases. This prospective study confirms the good diagnostic performance of Gadofosveset MRI for nodal (re)staging in rectal cancer. • Gadofosveset-enhanced MRI shows high performance for nodal (re)staging in rectal cancer. • Gadofosveset MRI may facilitate better selection of patients for personalised treatment. • Results can be reproduced by non-expert readers. • Experience of 50–60 cases is required to achieve required expertise level. • Main pitfalls are nodes located between vessels and nodes containing micrometastases.
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Performance of Gadofosveset-enhanced MRI for staging rectal cancer nodes: can the initial promising results be reproduced?
2013Co-Authors: Luc A Heijnen, Doenja M J Lambregts, Monique Maas, Milou H Martens, Robert G Riedl, Frans C H Bakers, Vincent C Cappendijk, Pedro Oliveira, Guido Lammering, Geerard L BeetsAbstract:Objectives A previous study showed promising results for Gadofosveset-trisodium as a lymph node magnetic resonance imaging (MRI) contrast agent in rectal cancer. The aim of this study was to prospectively confirm the diagnostic performance of Gadofosveset MRI for nodal (re)staging in rectal cancer in a second patient cohort.
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Gadofosveset enhanced mri for the assessment of rectal cancer lymph nodes predictive criteria
2013Co-Authors: Doenja M J Lambregts, Luc A Heijnen, Monique Maas, Iris J G Rutten, Milou H Martens, Walter H Backes, Robert G Riedl, Frans C H Bakers, Vincent C Cappendijk, Geerard L BeetsAbstract:To confirm the use of the nodal signal intensity (SI) and the ‘chemical shift’ artefact as diagnostic criteria for detecting nodal metastases from rectal cancer on Gadofosveset contrast-enhanced MRI. Thirty-three patients underwent a non-enhanced and Gadofosveset-enhanced 3D-T1W GRE-MRI at 1.5T. For each lymph node, the SI of the middle part of the node (mSI) and white rim of the chemical shift artefact encircling the node (wSI) were measured on the non-enhanced and Gadofosveset-enhanced images. Second, the aspect of the chemical shift artefact encircling the nodes was scored using a 4-point scale. Results were compared with histology on a node-by-node basis. 289 nodes (55 N+) were analysed. On Gadofosveset-MRI, mSI and wSI were significantly higher for the benign than for the metastatic lymph nodes (p < 0.001). Areas under the ROC curve (AUC) for identification of metastases were 0.74 (mSI) and 0.73 (wSI). The chemical shift criterion rendered an AUC of 0.85. The combination of mSI and the chemical shift criterion resulted in an AUC of 0.88 and the rendered an AUC of 0.86–0.92 when subjectively (visually) assessed by two independent readers. Benign lymph nodes show significant contrast enhancement after Gadofosveset injection, while metastatic nodes do not. The uptake of Gadofosveset in the nodes also affects the chemical shift artefact encircling the nodes. Combined assessment of these two features on Gadofosveset-enhanced MRI provides a high diagnostic performance for diagnosing metastatic lymph nodes in patients with rectal cancer.
