- Intra-Arterial Chemotherapy for Retinoblastoma in Infants ≤10 kg: 74 Treated Eyes with 222 IAC Sessions
Intra-arterial chemotherapy (IAC) for retinoblastoma (Rb) has dramatically altered the natural history of the disease. Cure rates, globe salvage, and vision preservation have dramatically increased. This retrospective chart review evaluated 207 Rb tumors of 207 eyes in 196 consecutive patients who underwent 658 IAC infusions overall. Patient weights were ≤10 kg in 69 (35.2%) and >10 kg in 127 (64.8%) patients. Comparison (≤10 kg versus >10 kg) revealed that the total number of IAC infusions was 222 versus 436. Periprocedural complications were not significantly different. The authors conclude that intra-arterial chemotherapy in patients weighing ≤10 kg is a safe and effective treatment.
- Spine MRI in Spontaneous Intracranial Hypotension for CSF Leak Detection: Nonsuperiority of Intrathecal Gadolinium to Heavily T2-Weighted Fat-Saturated Sequences
The authors performed a retrospective study of patients with spontaneous intracranial hypotension examined from February 2013 to October 2017. The spine MR imaging was reviewed by 3 blinded readers for the presence of epidural CSF using 3 different sequences (T2WI, 3D T2WI fat-saturated, T1WI gadolinium). In patients with leaks, the presumed level of the leak was reported. They conclude that intrathecal gadolinium-enhanced spine MR imaging does not improve the diagnostic accuracy for the detection of epidural CSF. Gadolinium myelography lacks a rationale to be included in the routine spontaneous intracranial hypotension work-up. Heavily T2-weighted images with fat saturation provide high accuracy for the detection of an epidural CSF collection.
- High Spatiotemporal Resolution 4D Flow MRI of Intracranial Aneurysms at 7T in 10 Minutes
The authors used pseudospiral Cartesian undersampling with compressed sensing reconstruction to achieve high spatiotemporal resolution (0.5mm isotropic, ∼30 ms) in a scan time of 10 minutes. They analyzed the repeatability of accelerated 4D-flow scans and compared flow rates, stroke volume, and the pulsatility index with 2D-flow and conventional 4D-flow MR imaging in a flow phantom and 15 healthy subjects. Mean flow-rate bias compared with 2D-flow was lower for accelerated than for conventional 4D-flow MR imaging. Pulsatility index bias gave similar results. Stroke volume bias showed no difference from accelerated bias for conventional 4D-flow MR imaging. Repeatability for accelerated 4D-flow was similar to that of 2D-flow MR imaging. They conclude that highly accelerated high-spatiotemporal-resolution 4D-flow MR imaging at 7T in intracranial arteries and aneurysms provides repeatable and accurate quantitative flow values.
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