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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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At least 937 records · Page 52
All sourcesNASA NTRSDOE OSTI
DOE OSTI2019

Percutaneous ureteral biopsy: safety and diagnostic yield

Purpose: To evaluate safety and diagnostic yield of percutaneous CT-guided biopsy of extrarenal upper urinary tract lesions. Materials and methods: Retrospective review of our institutional database of image-guided biopsies yielded 44 CT-guided percutaneous biopsies in 44 unique patients that targeted ureteral (30, 68%) or other non-renal upper urinary tract lesions (14, 32%) between January 1, 2000 and May 1, 2017. Indications, pre-biopsy imaging, biopsy technique, peri-procedural antithrombotic use, complications including bleeding defined by Society of Interventional Radiology criteria, pathology results, and subsequent imaging were reviewed up to 3 months after the procedure to evaluate safety and diagnostic yield. Results: Mean patient age was 66 (range 27–88) and 23/44 patients were male. The majority (34/44) of lesions were sampled with an 18-gauge biopsy device via a 17-gauge introducer needle, and the remaining 10/44 lesions were sampled with a 19/20 gauge system. The mean number of core samples obtained was 4 (range 2–10). No major complications occurred. Specifically, no patient developed a urine leak or urinary obstruction. Minor complications occurred in 3/44 (7%) biopsies, all retroperitoneal hemorrhages that did not require transfusion or other intervention. Biopsy was adequate for pathologic examination in 41 of 44 (93%) cases. Among patients undergoing surgical resection, biopsy diagnosis was concordant with surgical pathology in 9/10 (90%) cases and discordant in 1/10 (10%). Conclusion: CT-guided percutaneous biopsy of upper urinary tract lesions can be performed safely, with high diagnostic yield, and with a high rate of concordance on subsequent surgical pathology.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Evaluation of acoustic radiation force impulse (ARFI) elastography as non-invasive diagnostic tool in living donor liver transplantation

Background and aims: Role of acoustic radiation force impulse (ARFI) elastography, in transplant setting, is not well established. We aimed to define the normal mean values of the liver stiffness by ARFI Elastography in healthy liver donors and to evaluate ARFI elastography as predictor of graft fibrosis post living donor liver transplant (LDLT) in comparison to other non-invasive methods (transient elastography [TE], APRI and FIB4). Patients and methods: A total of 100 subjects (70 recipients and 30 donors) were recruited. APRI and FIB4 scores were calculated for all recipients. TE and ARFI elastography (Siemens Acuson S2000 Ultrasound System, Germany) were performed to all subjects. All donors and only 30 recipients had liver biopsy. Significant fibrosis was defined as ≥ F2. Results: The mean ARFI velocity among the donors was 1.05 ± 0.09 m/s. Regarding the recipients: mean age was 49.5 ± 8.49 years, 85.7% males, fibrosis stages < F2 were the most frequent stages by liver biopsy (86.7%) and TE (67.1%). ARFI median was significantly correlated with TE median, APRI and FIB-4 (r = 0.888, p = 0.000; r = 0.62, p = 0.000, and r = 0.585, p = 0.000, respectively). ARFI performed well in discriminating patients with ≥ F2 (AUROC = 0.93, 95% CI 0.86–0.99, p < 0.01) with best cutoff median value of 1.34 m/s (sensitivity 90%, specificity 82%). Conclusion: ARFI can be used as a reliable method in assessment of significant fibrosis post-LDLT.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Renal solitary fibrous tumor/hemangiopericytoma: computed tomography findings and clinicopathologic features

Purpose: To retrospectively characterize the clinical, pathological, and computed tomography (CT) findings of renal solitary fibrous tumor/hemangiopericytoma (rSFT/HPC). Methods: Twelve patients with rSFT/HPCs were enrolled. The CT findings and clinicopathological features were retrospectively reviewed. Results: This study included six male and six female patients (median age: 47; age range: 20–82 years). Eight benign (grade I) and four malignant (grade III) rSFT/HPCs were identified. Of the 12 lesions, 10 were in the renal sinus near the renal pelvis, while two replaced the whole kidney. Five lesions were well-defined, five were partially ill-defined, and two were ill-defined. Mild (5/12) and intermediate (1/12) hydronephrosis was observed. On the unenhanced CT images, ten tumors showed slightly higher density when compared to the normal renal parenchyma, and two masses were isodense to hypodense. After intravenous contrast medium injection, three enhancement patterns were observed, including “prolonged enhancement” (PE) (6/12), “gradual enhancement” (4/12), and “early washout” (2/12). A central fibrous scar was found in five patients. Compared to the grade I lesions, the grade III rSFT/HPC lesions tended to be larger (maximal diameter > 10 cm) and more heterogeneous with a higher incidence of the PE pattern. Conclusions: We have shown that rSFT/HPCs usually arise from the renal sinus, and present as lobulated, slightly hyperdense, gradually enhancing soft tissue masses. CT findings, including large size, heterogeneity, and the PE pattern, may assist in the pre-operative identification of malignant grade III rSFT/HPCs.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Assessing liver function: diagnostic efficacy of parenchymal enhancement and liver volume ratio of Gd-EOB-DTPA-enhanced MRI study during interstitial and hepatobiliary phase

Aim: To assess the efficacy of signal intensity in interstitial and hepatobiliary phase normalized for liver volume, on gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) study, for the evaluation of liver function through the comparison with Child–Pugh (CP), model for end-stage liver disease (MELD), and biochemical tests. Methods: All dynamic Gd-EOB-DTPA MRI studies performed in patients with suspected liver lesions were retrospectively reviewed. The rate of liver-to-muscle ratio on T1 sequence 70 s (interstitial phase) and 20 min (hepatobiliary phase) after injection of Gd-EOB-DTPA was calculated for each MRI study and then normalized for liver volume (irINTnorm and irHEPnorm). Pearson correlation coefficient was computed to assess the correlation among these values and CP and MELD scores, and biochemical tests. Results: A total of 303 MRI studies, performed on 221 patients, were included. Mean age was 63.8 years ± 12.9 with a majority of male patients (186; 61.4%). A total of 186 out of 303 (61.4%) were cirrhotic patients. The irHEPnorm was significantly lower in cirrhotic than non-cirrhotic patients (0.0004 ± 0.0002 to 0.0005 ± 0.0003, p = 0.010). This value had a moderate, significant correlation with Child–Pugh and MELD scores (R = − 0.292, p < 0.0001 and R = − 0.192, p = 0.010, respectively). In particular, irHEPnorm progressively decreased from Child–Pugh A to C (0.0004–0.0002, p < 0.0001) and from MELD ≤ 10 to 19–24 (0.0004–0.0003, p = 0.018). Among biochemical parameters, total bilirubin, GOT, and albumin had the strongest correlation with irHEPnorm (R = − 0.258, − 0.291, and 0.262, p < 0.0001, respectively). No correlations were found between irINTnorm and CP and MELD scores. Conclusion: irHEPnorm value derived from Gd-EOB-DTPA-enhanced MRI is a reliable, non-invasive, useful tool to quantify liver function and to assess the degree of cirrhosis, offering a strict relationship with clinical scores and biochemical parameters. This could help surgeons in clinical decision-making, allowing them to choose the more suitable surgical approach for cirrhotic patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Association of advanced hepatic fibrosis and sonographic visualization score: a dual-center study using ACR US LI-RADS

Purpose: To evaluate the association between imaging and clinical features and visualization scores, as specified by American College of Radiology (ACR) Ultrasound Liver Imaging Reporting and Data System (LI-RADS), on hepatocellular carcinoma (HCC) screening ultrasound examinations. Methods: In this dual-center retrospective study, HCC screening ultrasound reports containing ultrasound elastography measurements (January to September, 2017) were reviewed. Ultrasound point shear wave elastography and 2-dimensional shear wave elastography were used to assess liver stiffness; median shear wave velocity was translated to METAVIR fibrosis scoring, per previously published data. Reports were analyzed for subject age, sex, reason for HCC screening, spleen size, fibrosis scores, and assigned ultrasound visualization scores. Jonckheere–Terpstra trend and Kendall’s tau-b coefficient analyses were performed. Results: 714 subjects (mean age 55; 51% male, 49% female) were included. 308 (43%) subjects had clinically declared cirrhosis; 406 (57%) did not. Majority (535, 75%) of exams were adequate (Visualization Score A), 156 (22%) moderately limited (Visualization Score B), and 23 (3%) severely limited (Visualization Score C). Increasing spleen size and patient age were associated with worsening visualization scores (p < 0.001). Suboptimal visualization was also associated with clinically significant fibrosis (≥ F2) by elastography (Kendall’s tau-b = 0.181, p < 0.001) and clinically declared cirrhosis (Kendall’s tau-b = 0.433, p < 0.001). There was no association with patient sex. Conclusion: Using ACR Ultrasound LI-RADS visualization score assessment, majority (75%) of HCC screening exams were diagnostically adequate, and only 3% were severely limited. Sonoelastographic diagnosis of clinically significant fibrosis, as well as clinical cirrhosis, increased patient age, and spleen size, were associated with greater diagnostic limitations.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Imaging findings of hemorrhagic hepatic cysts with enhancing mural nodules

Purpose: This study aimed to evaluate the clinical and radiological findings of hemorrhagic hepatic cysts with enhancing mural nodules. Methods: The radiology databases of five facilities were retrospectively searched for reports indicating hemorrhagic hepatic cysts or hepatic cystic tumors. Cases of hemorrhagic hepatic cysts with enhancing mural nodules based on pathological or radiological findings were identified and reviewed. Results: We included 14 cases (11 female and 3 male) with a mean patient age of 72.6 years. Up until the enhancing mural nodules were detected, the cysts had decreased in size in all ten cases for which radiological imaging was available for a period of > 3 years previous to detection. Dynamic contrast-enhanced CT or MRI showed focal enhancement in the early phase and progressive centrifugal enhancement in the delayed phase in all 16 mural nodules ≥ 10 mm in diameter. Thirteen of 14 MRI assessable enhancing mural nodules ≥ 10 mm in diameter showed a hypointense rim with central hyperintensity on T2-weighted imaging. All cases showed calcification of the cyst wall. In the three referred cases, {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/CT demonstrated no intense FDG uptake in the enhancing mural nodules. In the four resected cases, histopathology of the enhancing mural nodules revealed neovascularization within an organized hematoma, including extensive dilated vessels and hemangioma-like lesions. Conclusions: Features including a decrease in cyst size, a progressive centrifugal enhancing pattern on dynamic contrast-enhanced CT or MRI, a hypointense rim with central hyperintensity on T2-weighted MRI, and cyst wall calcification may indicate a hemorrhagic hepatic cyst.

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DOE OSTI2019

Transnasal stent-assisted targeting technique for percutaneous jejunostomy placement in patients with hiatal hernias

Purpose: To report the transnasal stent-assisted targeting technique for percutaneous jejunostomy placement in patients with hiatal hernias. Materials and methods: Four patients, including three (75%) females and one (25%) male, with mean age of 77.5 years (range 73–78 years), and with a hiatal hernia and intrathoracic stomach precluding gastrostomy placement and loop snare placement into the mid-jejunum underwent the transnasal stent-assisted targeting technique for percutaneous jejunostomy placement. In all patients, a duodenal stent was inserted into the jejunum in a transnasal fashion. The stent was partially unsheathed in an anterior loop of jejunum and percutaneously targeted using an 18-gauge needle through which a guidewire was advanced, trapped within the stent, and removed through the nose. The tract was serially dilated and a jejunostomy was placed. Technical success, procedure time, fluoroscopy time, radiation exposure, complications, time to enteral feeding, and follow-up were recorded. Results: Technical success was 100% (4/4) with all four patients requiring only one needle pass before successful jejunal cannulation. Mean procedure time was 108 min. Mean fluoroscopy time was 44 min. Mean dose area product was 3969.3 μGym{sup 2}. No minor or major complications occurred. All four patients received enteral feeding one day after the procedure. Mean follow-up was 366 days. Conclusion: The transnasal stent-assisted targeting technique is a novel method for primary jejunostomy placement in patients with hiatal hernias.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Quantification of fat and skeletal muscle tissue at abdominal computed tomography: associations between single-slice measurements and total compartment volumes

Purpose: Body composition is of great prognostic value in several severe diseases, including different types of cancer as well as cardiometabolic disorders. We aimed to investigate the correlations of skeletal muscle mass and abdominal adipose tissue compartments between volumetric and single-slice measurements to study the usefulness of several anatomical landmarks for estimation of total compartment volumes using abdominal CT-scans. Methods: In this retrospective study volumetric quantifications of paraspinal skeletal muscles (SM) and adipose tissue compartments (visceral adipose tissue, VAT; subcutaneous adipose tissue, SAT) were performed in 50 consecutive patients (26 male; mean age, 63 ± 15 years) who underwent abdominal multislice-CT for diagnostic purposes using an in-house software. Associations between total volumes of SM, VAT, and SAT with single-slice measurements at eight predefined anatomical landmarks (median intervertebral disk spaces T12/L1 to L5/S1; level of the umbilicus (U); level of the radix of the superior mesenteric artery (SMA)) were studied using correlation coefficients. Results: Statistical analysis revealed a strong association between single-slice measurements of adipose tissue compartments with total VAT and SAT volume (VAT: all r > 0.89, P < 0.001; SAT: all r > 0.95, P < 0.001). The strongest associations with total SM volume were found for single-slice measurements obtained at L3/4 (r = 0.94, P < 0.001) and were further improved by normalization to height (r = 0.98, P < 0.001). Conclusions: Single-slice measurements of SM, VAT, and SAT at several anatomical landmarks are strongly associated with total compartment volumes and therefore allow for easy and simultaneous assessment of skeletal muscle mass and adipose tissue compartment volumes.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

CT and MRI features of undifferentiated carcinomas with osteoclast-like giant cells of the pancreas: a case series

Purpose: The purpose of this case series was to describe computed tomography (CT) and magnetic resonance imaging (MRI) features of undifferentiated carcinoma with osteoclast-like giant cells of the pancreas. Methods: Institutional ethics review board approval was obtained, and informed consent was waived for this case series. We reviewed CT and MRI of patients with pathologically confirmed undifferentiated carcinoma with osteoclast-like giant cells of the pancreas found in the medical records of our hospital between 2006 and 2016. Results: Seven patients (3 males and 4 females; age, 59–82 years (mean, 71)) with confirmation by surgical resection (n = 3) or biopsy (n = 4) were identified. They underwent CT (n = 7) and MRI (n = 6). The tumors 26–83 mm in diameter (mean, 44 mm) were located in the head (n = 4) or body (n = 3) of the pancreas. They were demonstrated as lower attenuation areas relative to the adjacent pancreas on CT images obtained in both pancreatic and portal vein phases (n = 7) with a well-defined smooth margin (n = 5). They were demonstrated as hypointense areas relative to the pancreas on T2-weighted images (n = 4) and T2*-weighted images (n = 4) and diffusion-weighted images (n = 3). They contained hemosiderin deposits on histology (n = 7). Conclusions: Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas might be present as low attenuation areas with a well-defined smooth margin on CT images obtained in pancreatic and portal vein phases, and hypointense areas on T2-, T2*-, and diffusion-weighted images caused by hemosiderin deposits.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Comparison of navigator-gated and breath-held image acquisition techniques for multi-echo quantitative dixon imaging of the liver in children and young adults

Purpose: Acquired over a breath hold, multi-echo Dixon (mDixon) magnetic resonance imaging (MRI) of the liver can be used to quantify proton density fat fraction (PDFF) and iron-related signal decay. However, young, obese, and co-morbid patients may have limited breath holding capacity and could benefit from a motion-robust mDixon acquisition. The purpose of this study was to compare hepatic PDFF and R2* values between navigator-gated and breath-held mDixon MRI acquisition techniques in children and young adults with suspected liver disease. Materials and methods: This retrospective study was institutional review board-approved with a waiver of informed consent. Patients who underwent liver MRI with breath-held and navigator-gated mDixon sequences between January 2017 and July 2018 were included. One reviewer, blinded to sequence, measured PDFF and R2* on four images from each sequence. Another blinded reviewer graded respiratory motion (5-point Likert scale). Pearson correlation (r), Lin’s concordance coefficients (r{sub c}), and Bland–Altman analyses were used to assess agreement between techniques. Frequency of clinically limiting motion (score ≥ 3) was compared with Fisher’s exact test. Results: Forty-two patients were included (15 female, 27 male; mean age: 15.7 ± 4.6 years). Mean PDFF and R2* were 16.6 ± 13.1% and 29.3 ± 4.7 s{sup −1} (breath-held) versus 17.0 ± 13.2% and 29.6 ± 5.2 s{sup −1} (navigator-gated). PDFF agreed almost perfectly between sequences (r{sub c} = 0.997, 95% CI 0.994–0.998; mean bias: 0.3%; 95% limits of agreement: − 2.4 to +1.7%), while R2* values correlated very strongly but with poor agreement (r = 0.837, r{sub c} = 0.832, 95% CI 0.716–0.910). Navigator-gated images exhibited significantly higher frequency of clinically limiting respiratory motion (88% vs. 48%, p = 0.0001). Conclusion: Despite greater respiratory motion artifact, a free-breathing navigator-gated mDixon sequence produces PDFF values with almost perfect agreement to a breath-held sequence.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2019

Diagnostic performance of magnetic resonance cholangiopancreatography (MRCP) versus endoscopic retrograde cholangiopancreatography (ERCP) in the pediatric population: a clinical effectiveness study

Purpose: To determine the diagnostic performance of magnetic resonance cholangiopancreatography (MRCP) for detecting biliary and pancreatic abnormalities in a pediatric population, using endoscopic retrograde cholangiopancreatography (ERCP) as the reference standard. Materials and methods: Institutional review board approval with a waiver of informed consent was obtained for this retrospective investigation. Records from the Cincinnati Children’s Hospital Medical Center, Division of Gastroenterology and Department of Radiology were used to identify patients aged ≤ 18 years who had undergone both ERCP and MRCP within a 4-week interval between January 2013 and May 2017. Biliary and pancreatic duct findings were documented for each modality to determine the diagnostic performance of MRCP (with 95% confidence intervals), using ERCP as the reference standard. Results: 54 patients met inclusion criteria. Mean patient age at time of ERCP was 10.4 ± 4.9 years, and 25 (46%) were male. Mean interval between ERCP and MRCP was 11.2 ± 9.7 days. For detection of any abnormality (n = 99 ERCP findings), MRCP had a sensitivity of 76.8% (67.5–84.0%) and a positive predictive value (PPV) of 81.7% (72.7–88.3%). MRCP was 75.7% (59.9–86.6%) sensitive, with a PPV of 84.9% (69.1–93.4%) for biliary findings (n = 37) and 73.5% (59.7–83.8%) sensitive, with a PPV of 78.3% (64.4–87.7%) for pancreatic findings (n = 49). For pancreatobiliary abnormalities (n = 13), MRCP had a sensitivity of 92.3% (66.7–99.6%) and a PPV of 85.7% (60.1–97.5%). Conclusion: In clinical practice, MRCP is moderately sensitive for biliary and pancreatic abnormalities, with false-negative and false-positive examinations being relatively common.

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DOE OSTI2019

Interobserver agreement of computed tomography reporting standards for chronic pancreatitis

Aim: To assess the interobserver agreement of computed tomography (CT) reporting standards for chronic pancreatitis (CP). Subjects and methods: Retrospective analysis of CT of 47 patients (33 males and 11 females, age range 36 to 56 years) with CP who presented with abdominal pain (n = 41), steatorrhea (n = 37), and glucose intolerance (n = 31). The patients underwent CT study using a 16-multidetector CT scanner with a pancreatic protocol including a nonenhanced scan followed by pancreatic phase at 35 s and portal venous phase at 65 s after intravenous injection of nonionic contrast medium. Image analysis was performed by two radiologists according to reporting standards for CP. Results: There was excellent interobserver agreement (84.8 %) between the two reviewers in CT reporting standards for CP (K = 0.80, 95 % CI 0.75–0.85, P = 0.001). There was good interobserver agreement for pancreatic duct (PD) caliber (K = 0.71, 95 % CI 0.56–0.87, P = 0.001), PD contour (K = 0.76, 95 % CI 0.61–0.91, P = 0.001), PD stricture (K = 0.070, 95 % CI 0.53–0.88, P = 0.001), and distribution of findings (K = 0.69, 95 % CI 0.51–0.86, P = 0.001). There was excellent interobserver agreement for intraductal calculi (K = 0.84, 95 % CI 0.68–0.98, P = 0.001), pancreatic calcifications (K = 0.86, 95 % CI 0.84–0.98, P = 0.001), and pancreatic diameter (K = 0.87, 95 % CI 0.75–0.99, P = 0.001). Conclusion: CT reporting standards for CP is a reliable method for diagnosis of patients with CP.

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DOE OSTI2019

Diffusion-weighted imaging as a part of PET/MR for small lesion detection in patients with primary abdominal and pelvic cancer, with or without TOF reconstruction technique

Objectives: To investigate the value of diffusion-weighted imaging (DWI) in detection of small lesions (≤ 10 mm) in patients with primary abdominal and pelvic cancer in hybrid PET/MR with or without time-of-flight (TOF) technique. Materials and methods: Twenty patients (11 females and 9 males, mean age 67.23 ± 12.90 years) with histologically confirmed primary abdominal and pelvic cancer underwent hybrid PET/MR examination. A total of 64 small lesions were included in this study, which were divided into two groups (≤ 10 mm and 10–30 mm). Visual scores of small lesion detection ability were rated by five-point ordinal scale. The visual scores and detectability of small lesions on TOF PET image, noTOF PET image, and DWI sequences of hybrid PET/MR examination with or without TOF technique were analyzed. Logistic regression model was established for analysis in the value of DWI in hybrid PET/MR examination with or without TOF technique in detection of the small lesions between two groups. Results: The visual evaluation revealed the small lesion (≤ 10 mm) visual scores of DWI (mean ± SD: 4.23 ± 1.41), TOF PET image (mean ± SD: 4.14 ± 0.89), and noTOF PET image (mean ± SD: 2.68 ± 1.13);.and the visual scores of small lesions (10–30 mm) on DWI (mean ± SD: 4.98 ± 0.15), TOF PET image (mean ± SD: 4.57 ± 0.59), and noTOF PET image (mean ± SD: 3.98 ± 1.05). The visual scores of all small lesions on DWI were higher than that on TOF PET data and noTOF PET data in both two groups (**P < 0.01). The missed diagnosis rates of small FDG avid lesions (≤ 10 mm) of DWI and noTOF PET image were 9.1% and 9.1%, respectively. However, the TOF PET-based clinical diagnosis detected all small lesions (≤ 30 mm). DWI was of great importance in detection of small lesions (≤ 10 mm) in the absence of TOF technique in PET/MR examination (**P < 0.01). DWI’s effect on detection of small lesions(10-30 mm) has shown no difference between PET/MR examinations with TOF and without TOF techniques (P > 0.05). Conclusion: DWI has significant value in the detection of small lesions (≤ 10 mm) in hybrid PET/MR examination without TOF technique for patients with primary abdominal and pelvic cancer. However, it had less detection benefits in the small lesions (≤ 10 mm) in hybrid PET/MR examination with TOF PET image.

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DOE OSTI2019

110 Patients with adenosquamous carcinomas of the pancreas (PASC): imaging differentiation of small (≤ 3 cm) versus large (> 3 cm) tumors

Objective: This study examined radiological imaging features of small (≤ 3 cm) and large (> 3 cm) adenosquamous carcinomas of the pancreas (PASC) lesions to better understand the morphology of these lesions. Methods: Images from 110 patients with pathologically proven PASC (80 males and 30 females, mean age: 62.6 years) were retrospectively reviewed. Two radiologists analyzed images and reached a consensus regarding the following features: location, shape, margins, presence of solid and necrotic components, rim enhancement, density/intensity during the portal venous phase, invasion of surrounding organs, vascular invasion, venous tumor thrombus formation, and enlarged lymph nodes. Differences in the imaging features between the two groups were evaluated with the Chi-square test or Fisher’s exact test. Results: There were 41 small PASC lesions (mean age: 60.59 years) and 69 large PASC lesions (63.74 years). Statistical analysis demonstrated significant differences in the location, shape, adjacent organ and vessel invasion, and venous tumor thrombus formation (P < 0.05). Small PASC lesions were more frequently detected in the pancreatic head and had an ovoid shape. There was no significant difference in the presence of solid and necrotic components (P = 0.090), including approximately 3/4 of the lesions with necrosis and 1/4 purely solid lesions, enlarged lymph nodes (P = 0.068) and other features. Conclusion: Regardless of the tumor size, 75% of PASC lesions present with central necrosis while 25% are purely solid. Small PASC lesions can be associated with lymph node metastasis at a relatively early stage. Large PASC lesions are likely to invade adjacent tissues and be associated with venous tumor thrombus formation.

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DOE OSTI2019

Transcatheter arterial infusion for pancreatic cancer: a 10-year National Cancer Center experience in 115 patients and literature review

Purpose: To evaluate the efficacy and safety of transcatheter arterial infusion (TAI) for the treatment of pancreatic cancer in patients ineligible for or refractory to systemic chemotherapy. Materials and methods: The medical records of 115 consecutive patients (mean age, 58.9 years; 71 males) with documented pancreatic cancer ineligible for or refractory to systemic chemotherapy and underwent TAI between February 2007 and January 2017 were reviewed. Results: A total of 224 TAI sessions [mean, 1.9 (range 1–8)] were performed. Technical success rate was 100%. Disease control (i.e., complete response, partial response, and stable disease) was achieved in 72 (62.6%) patients. The median progression-free survival and median overall survival were 56 days and 147 days, respectively. Subgroup analysis revealed that disease control, progression-free survival, and overall survival were significantly improved in patients with an Eastern Cooperative Oncology Group score of ≤ 1 compared with those in patients with an Eastern Cooperative Oncology Group score of 2 (all p < 0.001) and in patients who received > 1 sessions of TAI compared with that in patients who received only 1 session of TAI (p = 0.012, < 0.001, and = 0.002, respectively). A major complication in the form of cerebral infarction occurred in 1 (0.9%) patient 1 day after the procedure. This patient was treated with conservative therapy and recovered without permanent adverse sequelae. No other major complications were observed. Conclusions: TAI may be effective and safe for the treatment of pancreatic cancer.

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DOE OSTI2019

Measurement of spleen fat on MRI-proton density fat fraction arises from reconstruction of noise

Purpose: This study compares splenic proton density fat fraction (PDFF) measured using confounder-corrected chemical shift-encoded (CSE)-MRI to magnetic resonance spectroscopy (MRS) in human patients at 3T. Methods: This was a prospectively designed ancillary study to various previously described single-center studies performed in adults and children with known or suspected nonalcoholic fatty liver disease. Patients underwent magnitude-based MRI (MRI-M), complex-based MRI (MRI-C), high signal-to-noise variants (Hi-SNR MRI-M and Hi-SNR MRI-C), and MRS at 3T for spleen PDFF estimation. PDFF from CSE-MRI methods were compared to MRS-PDFF using Wilcoxon signed-rank tests. Demographics were summarized descriptively. Spearman’s rank correlations were computed pairwise between CSE-MRI methods. Individual patient measurements were plotted for qualitative assessment. A significance level of 0.05 was used. Results: Forty-seven patients (20 female, 27 male) including 12 adults (median 55 years old) and 35 children (median 12 years old). Median PDFF estimated by MRS, MRI-M, Hi-SNR MRI-M, MRI-C, and Hi-SNR MRI-C was 1.0, 2.3, 1.9, 2.2, and 2.0%. The four CSE-MRI methods estimated statistically significant higher spleen PDFF values compared to MRS (p < 0.0001 for all). Pairwise associations in spleen PDFF values measured by different CSE-MRI methods were weak, with the highest Spearman’s rank correlations being 0.295 between MRI-M and Hi-SNR MRI-M; none were significant after correction for multiple comparisons. No qualitative relationship was observed between PDFF measurements among the various methods. Conclusion: Overestimation of PDFF by CSE-MRI compared to MRS and poor agreement between related CSE-MRI methods suggest that non-zero PDFF values in human spleen are artifactual.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

The Effect of Endovascular Revascularization of Common Iliac Artery Occlusions on Erectile Function

To determine the incidence of erectile dysfunction in patients with common iliac artery (CIA) occlusive disease and the effect of revascularization on erectile function using the sexual health inventory for males (SHIM) questionnaire. All patients (35 men; mean age 57 {+-} 5 years; range 42-67 years) were asked to recall their sexual function before and 1 month after iliac recanalization. Univariate and multivariate analyses were performed to determine variables effecting improvement of impotence. The incidence of impotence in patients with CIA occlusion was 74% (26 of 35) preoperatively. Overall 16 (46%) of 35 patients reported improved erectile function after iliac recanalization. The rate of improvement of impotence was 61.5% (16 of 26 impotent patients). Sixteen patients (46%), including seven with normal erectile function before the procedure, had no change. Three patients (8%) reported deterioration of their sexual function, two of whom (6%) had normal erectile function before the procedure. The median SHIM score increased from 14 (range 4-25) before the procedure to 20 (range 1-25) after the procedure (P = 0.005). The type of recanalization, the age of the patients, and the length of occlusion were related to erectile function improvement in univariate analysis. However, these factors were not independent factors for improvement of erectile dysfunction in multivariate analysis (P > 0.05). Endovascular recanalization of CIA occlusions clearly improves sexual function. More than half of the patients with erectile dysfunction who underwent endovascular recanalization of the CIA experienced improvement.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2013

Hemophilic Chronic Synovitis: Therapy of Hemarthrosis using Endovascular Embolization of Knee and Elbow Arteries

PurposeCongenital hemophilia is a hereditary bleeding disorder that affects 1 in 5,000 males and is characterized by repetitive musculoskeletal bleeding episodes. Selective embolization of the knee and elbow arteries can prevent bleeding episodes. To evaluate the long-term efficacy of these procedures, we assessed the outcomes of 30 procedures performed in our center.MethodsWe performed 30 procedures in 27 hemophilic patients, including 23 knee, and 7 elbow procedures. To evaluate the efficacy of selective embolization of knee and elbow arteries in people with hemophilia, we analyzed the number of bleeding episodes during 12 months before the procedure compared with the amount of episodes that occurred 3, 6, and 12 months after embolization.ResultsTwenty-nine of 30 procedures were classified as successful. The median of 1.25 episodes per month (range 0-3) observed before the procedure was reduced to 0 (range 0-1.67; p < 0.001) at 3 months, 0.17 (range 0-1.67; p < 0.001) at 6 months, and 0.33 (range 0-1.67; p = 0.024) at 12 months. Three patients remained free of bleeding events for more than 6 months. Additionally, after the procedure there was a significant reduction in factor FVIII usage that sustained up to 12 months after the procedures. No serious adverse events were observed.ConclusionsSelective angiographic embolization of knee and elbow arteries is a feasible procedure that can prevent repetitive bleedings, which would translate in better joint outcomes for these patients.

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