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Cleveland, OH, United States

Loffroy R.,Interventional Imaging
World Journal of Gastroenterology | Year: 2013

Acute massive duodenal bleeding is one of the most frequent complications of peptic ulcer disease. Endoscopy is the first-line method for diagnosing and treating actively bleeding peptic ulcers because its success rate is high. Of the small group of patients whose bleeding fails to respond to endoscopic therapy, increasingly the majority is referred for embolotherapy. Indeed, advances in catheter-based techniques and newer embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the management of hemorrhage from peptic ulcers over the past decade. Embolization may be effective for even the most gravely ill patients for whom surgery is not a viable option, even when extravasation is not visualized by angiography. However, it seems that careful selection of the embolic agents according to the bleeding vessel may play a role in a successful outcome. The role of the surgeon in this clinical sphere is dramatically diminishing and will certainly continue to diminish in ensuing years, surgery being typically reserved for patients whose bleeding failed to respond all previous treatments. Such a setting has become extremely rare. © 2013 Baishideng. All rights reserved. Source


Griffith J.F.,Interventional Imaging | Genant H.K.,University of California at San Francisco
Endocrine | Year: 2012

Tremendous advances have been made over the past several decades in assessing osteoporosis and its complications. High resolution imaging combined with sophisticated computational techniques now provide a detailed analysis of bone structure and a much more accurate prediction of bone strength. These techniques have shown how different mechanisms of age-related bone weakening exist in males and females. Limitations peculiar to these more advanced imaging techniques currently hinder their adoption into mainstream clinical practice. As such, the ultimate quest remains a readily available, safe, high resolution technique capable of fully predicting bone strength, capable of showing how bone strength is faltering and precisely monitoring treatment effect. Whether this technique will be based on acquisition of spine/hip data or data obtained at peripheral sites reflective of changes happening in the spine and hip regions is still not clear. In the meantime, mainstream imaging will continue to improve the detection of osteoporosis related insufficiency fracture in the clinical setting. We, as clinicians, should aim to increase awareness of this fracture type both as a frequent and varied source of pain in patients with osteoporosis and as the ultimate marker of severely impaired bone strength. © Springer Science+Business Media, LLC 2012. Source


Behr G.G.,Morgan Stanley | Johnson C.,Interventional Imaging
American Journal of Roentgenology | Year: 2013

OBJECTIVE. The purpose of this study was to review the medical literature and the current classification of vascular anomalies to clarify common misconceptions and provide guidance for imaging and treatment. In this first article of a two-part series, we focus on the fast-flow vascular anomalies. CONCLUSION. Nonuniformity of terminology across the medical literature hampers understanding of the vascular anomalies. A familiarity with the classification and biology on which this terminology is based is essential for accurate and precise diagnosis. © American Roentgen Ray Society. Source


Hasan K.M.,Interventional Imaging | Frye R.E.,University of Texas Health Science Center at Houston
Human Brain Mapping | Year: 2011

In this communication, we extended a previously described and validated diffusion tensor imaging (DTI) method for segmenting whole brain cerebrospinal fluid (CSF) and gray and white matter (WM) tissue to provide regional volume and DTI metrics of WM tract and cortical and subcortical gray matter. This DTI-based regional segmentation was implemented using the statistical parametric mapping (SPM) toolbox and used the international consortium for brain mapping atlases and Montreal Neurological Institute brain templates. We used our DTI-based segmentation approach to calculate the left putamen volume in a cohort of 136 healthy right-handed males and females aged 15.8-62.8 years. We validated our approach by demonstrating its sensitivity to age-related changes of the putamen. Indeed, our method found that the putamen volume decreased with age (r = -0.30; P < 0.001) while the corresponding fractional anisotropy (FA) increased with advancing age (r = 0.5; P < 0.00001). It is then demonstrated, on a subset of our cohort (n = 31), that the putamen volume obtained by our method correlated with measurements obtained from FreeSurfer (r = 0.396, P < 0.05). Our novel approach increases the information obtained with a DTI examination by providing routine volumetry measure, thereby eliminating separate scans to obtain volumetry data. In addition, the labeled volumes obtained with our method have the potential to increase the accuracy of fiber tracking. In the future, this new approach can be automated to analyze large data sets to help discover noninvasive neuroimaging markers for clinical trials and brain-function studies in both health and disease. Hum Brain Mapp, 2010. © 2010 Wiley-Liss, Inc. Source


Camici P.G.,San Raffaele Scientific Institute | Rimoldi O.E.,CNR Institute of Neuroscience | Gaemperli O.,Interventional Imaging | Libby P.,Brigham and Womens Hospital
European Heart Journal | Year: 2012

Over the last several decades, basic cardiovascular research has significantly enhanced our understanding of pathobiological processes leading to formation, progression, and complications of atherosclerotic plaques. By harnessing these advances in cardiovascular biology, imaging has advanced beyond its traditional anatomical domains to a tool that permits probing of particular molecular structures to image cellular behaviour and metabolic pathways involved in atherosclerosis. From the nascent atherosclerotic plaque to the death of inflammatory cells, several potential molecular and micro-anatomical targets for imaging with particular selective imaging probes and with a variety of imaging modalities have emerged from preclinical and animal investigations. Yet, substantive barriers stand between experimental use and wide clinical application of these novel imaging strategies. Each of the imaging modalities described herein faces hurdles-for example, sensitivity, resolution, radiation exposure, reproducibility, availability, standardization, or costs. This review summarizes the published literature reporting on functional imaging of vascular inflammation in atherosclerotic plaques emphasizing those techniques that have the greatest and/or most immediate potential for broad application in clinical practice. The prospective evaluation of these techniques and standardization of protocols by multinational networks could serve to determine their added value in clinical practice and guide their development and deployment. © 2012 The Author. Source

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