Case Center for Imaging Research

Cleveland, OH, United States

Case Center for Imaging Research

Cleveland, OH, United States
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News Article | May 17, 2017
Site: www.sciencedaily.com

A diagnostic MRI followed by one of three MRI-guided biopsy strategies is a cost-effective method to detect prostate cancer, according to a new study out of Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center. Researchers compared MR-guided approaches to the current standard of transrectal ultrasound guided biopsies and found that these approaches yielded net health benefits that were well within commonly accepted threshold for costs-benefit ratios and thus are cost-effective strategies for detecting prostate cancer. The paradigm-shifting research was published in the preeminent journal Radiology. "Many consider MRIs to be cost-prohibitive, especially when evaluating for a common entity such as prostate cancer. This was our expectation as well, prior to doing this work, but our study found the opposite. We found that performing MRI before biopsy and using that information to alter biopsy pathways would be a strategy that would add health benefits to the patient population in a cost effective manner," said Vikas Gulani, MD, PhD, study advisor and associate professor of radiology, urology, and biomedical engineering at Case Western Reserve University School of Medicine, and member of both the Case Comprehensive Cancer Center and Case Center for Imaging Research. The study was jointly first-authored by Shivani Pahwa, MD, department of radiology, and Nicholas Schiltz, PhD, department of biostatistics; and was developed in close collaboration with Lee Ponsky, MD, department of urology, and Mark Griswold, PhD, department of radiology. The researchers found using MRI to help detect lesions and guide biopsies increased standardized quality-adjusted life years for patients and was cost-effective in 94.05% of simulations. The benefits were consistent across age groups, and could change how doctors identify and sample cancer lesions. The current standard of care for detecting prostate cancer involves 12 biopsy samples collected during an invasive transrectal ultrasound. Since most tumors are not visible on ultrasound, up to 40% of clinically significant tumors are missed via this method, and many found are clinically insignificant. The approach regularly results in patients entering treatment pathways with potential negative side effects, to treat low-risk tumors. Biopsies may also cause bleeding and complications, increasing health care costs. MRI offers a non-invasive alternative to transrectal ultrasound which can help better steer biopsy pathways. Doctors could use MRI to evaluate patients for potentially harmful lesions, and then use that information in one of three MRI guided strategies for biopsying potential foci of cancer, and bypass biopsy if a scan is completely negative. Although scans are expensive, they can add health benefits by triaging patients into proper treatment pathways. MR tends to miss low risk cancer, the overtreatment of which is a major contributor to high health and financial costs in prostate cancer. Similarly, a negative MRI is a very good predictor of exclusion of aggressive disease. A combination of such factors is likely the reason for the cost effectiveness of the MRI guided strategies. Current estimates place prostate cancer care costs in the United States at over $10 billion annually, and the price tag is rising. The findings may help streamline prostate cancer treatment protocols to better serve patients. Said Gulani, "Costs are escalating in part due to expensive and inefficient diagnostic pathways, and placement of patients in incorrect treatment groups. If we can maximize efficiency in how we identify clinically significant lesions and diagnose patients, we can reduce unnecessary treatments for our patients, and reduce costs to our hospitals."


News Article | May 17, 2017
Site: www.eurekalert.org

A diagnostic MRI followed by one of three MRI-guided biopsy strategies is a cost-effective method to detect prostate cancer, according to a new study out of Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center. Researchers compared MR-guided approaches to the current standard of transrectal ultrasound guided biopsies and found that these approaches yielded net health benefits that were well within commonly accepted threshold for costs-benefit ratios and thus are cost-effective strategies for detecting prostate cancer. The paradigm-shifting research was published in the preeminent journal Radiology. "Many consider MRIs to be cost-prohibitive, especially when evaluating for a common entity such as prostate cancer. This was our expectation as well, prior to doing this work, but our study found the opposite. We found that performing MRI before biopsy and using that information to alter biopsy pathways would be a strategy that would add health benefits to the patient population in a cost effective manner," said Vikas Gulani, MD, PhD, study advisor and associate professor of radiology, urology, and biomedical engineering at Case Western Reserve University School of Medicine, and member of both the Case Comprehensive Cancer Center and Case Center for Imaging Research. The study was jointly first-authored by Shivani Pahwa, MD, department of radiology, and Nicholas Schiltz, PhD, department of biostatistics; and was developed in close collaboration with Lee Ponsky, MD, department of urology, and Mark Griswold, PhD, department of radiology. The researchers found using MRI to help detect lesions and guide biopsies increased standardized quality-adjusted life years for patients and was cost-effective in 94.05% of simulations. The benefits were consistent across age groups, and could change how doctors identify and sample cancer lesions. The current standard of care for detecting prostate cancer involves 12 biopsy samples collected during an invasive transrectal ultrasound. Since most tumors are not visible on ultrasound, up to 40% of clinically significant tumors are missed via this method, and many found are clinically insignificant. The approach regularly results in patients entering treatment pathways with potential negative side effects, to treat low-risk tumors. Biopsies may also cause bleeding and complications, increasing health care costs. MRI offers a non-invasive alternative to transrectal ultrasound which can help better steer biopsy pathways. Doctors could use MRI to evaluate patients for potentially harmful lesions, and then use that information in one of three MRI guided strategies for biopsying potential foci of cancer, and bypass biopsy if a scan is completely negative. Although scans are expensive, they can add health benefits by triaging patients into proper treatment pathways. MR tends to miss low risk cancer, the overtreatment of which is a major contributor to high health and financial costs in prostate cancer. Similarly, a negative MRI is a very good predictor of exclusion of aggressive disease. A combination of such factors is likely the reason for the cost effectiveness of the MRI guided strategies. Current estimates place prostate cancer care costs in the United States at over $10 billion annually, and the price tag is rising. The findings may help streamline prostate cancer treatment protocols to better serve patients. Said Gulani, "Costs are escalating in part due to expensive and inefficient diagnostic pathways, and placement of patients in incorrect treatment groups. If we can maximize efficiency in how we identify clinically significant lesions and diagnose patients, we can reduce unnecessary treatments for our patients, and reduce costs to our hospitals." Funding for the study was provided in part by Siemens Healthcare (to V.G., M.A.G., and S.P.) and National Institutes of Health National Center for Advancing Translational Sciences grant KL2TR000440 (to N.K.S). For more information about Case Western Reserve University School of Medicine, please visit: http://case. . For more information about University Hospitals Cleveland Medical Center, please visit: UHhospitals.org.


Ni T.,Changzhou University | Ni T.,Jiangnan University | Gu X.,Changzhou University | Gu X.,Jiangnan University | And 6 more authors.
Journal of Information Science and Engineering | Year: 2015

Manifold regularization, which learns from a limited number of labeled samples and a large number of unlabeled samples, is a powerful semi-supervised classifier with a solid theoretical foundation. However, manifold regularization has the tendency to misclassify data near the boundaries of different classes during the classification process. In this paper, we propose a novel classification method called locality preserving semi-supervised support vector machine (LPSSVM) with an extended manifold regularization framework based on within-class locality preserving scatter. LPSSVM is good at exploring the underlying discriminative information as well as the local geometry of the samples as much as possible rather than merely relying on the smoothness information regarding manifold regularization. Meanwhile, benefiting from the geodesic distance metric, LPSSVM can more effectively reflect the true local geometry of data instances in the manifold space, which further strengths its accuracy in reality. The extensive comparisons with respect to LPSSVM and several state-of-the-art approaches were carried out on both artificial and real-word data sets. These experimental studies demonstrate the advantages as well as the superiority of our proposed method.


Perera V.S.,Kent State University | Hao J.,Case Center for Imaging Research | Hao J.,Case Western Reserve University | Gao M.,Kent State University | And 6 more authors.
Inorganic Chemistry | Year: 2011

An aqueous synthetic procedure for preparing nanoparticles of the novel potassium bismuth ferrocyanide coordination polymer KBi(H 2O) 2[Fe(CN) 6]·H 2O is reported. The crystal structure of this coordination polymer is determined through X-ray powder diffraction using the bulk materials. The stability, cytotoxicity, and potential use of such nanoparticles coated with PVP as a CT contrast agent are investigated. © 2011 American Chemical Society.


Frullano L.,Case Center for Imaging Research | Wang C.,Case Center for Imaging Research | Miller R.H.,Case Western Reserve University | Wang Y.,Case Center for Imaging Research
Journal of the American Chemical Society | Year: 2011

Myelination is one of the most fundamental biological processes in the development of vertebrate nervous systems. Abnormal or disrupted myelination occurs in many acquired or inherited neurodegenerative diseases, including multiple sclerosis (MS) and various leukodystrophies. To date, magnetic resonance imaging (MRI) has been the primary tool for diagnosing and monitoring the progression of MS and related diseases; however, any change in signal intensity of conventional MRI reflects a change only in tissue water content, which is a nonspecific measure of the overall changes in macroscopic tissue injury. Thus, the use of MRI as a primary measure of disease activity was shown to be disassociated from the clinical outcome due to the lack of specificity for myelination. In order to increase the MRI specificity for myelin pathologies, we designed and synthesized the first Gd-based T 1 MR contrast agent (MIC) that binds to myelin with high specificity. In this Communication, we demonstrate that MIC localizes in brain regions in proportion to the extent of myelination. In addition, MIC possesses promising MR contrast properties, which allow for direct detection of myelin distribution through T 1 mapping in the mouse brain. © 2011 American Chemical Society.


PubMed | University of Michigan and Case Center for Imaging Research
Type: Journal Article | Journal: Journal of pharmaceutical sciences | Year: 2016

In situ-forming implants are a promising platform used for the release of therapeutic agents. Significant changes in behavior occur when the implants are used in vivo relative to implants formed in vitro. To understand how the injection site effects implant behavior, poly(lactic-co-glycolic acid) implants were examined after injection in the subcutaneous space of a Sprague-Dawley rat model to determine how the environment altered implant erosion, degradation, swelling, microstructure, and mock drug release. Changes in implant microstructure occurred over time for implants formed in vivo, where it was observed that the porosity was lost over the course of 5 days. Implants formed in vivo had a significantly greater burst release (p < 0.05) relative to implants formed in vitro. However, during the diffusion period of release, implants formed in vitro had a significantly higher daily release (2.1%/day, p < 0.05), which correlated to changes in implant microstructure. Additionally, implants formed in vitro had a two-fold increase in the first-order degradation kinetics relative to the implants formed in vivo. These findings suggest that the changes in implant behavior occur as a result of changes in the implant microstructure induced by the external environment.

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