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Biomedical subjects

Matthew A Barish

Publications and source records attributed to Matthew A Barish.

9 recordsLinked to original sources
PubMed2006

Three-dimensional fast-recovery fast spin-echo MRCP: comparison with two-dimensional single-shot fast spin-echo techniques.

PURPOSE: To retrospectively evaluate the technical quality of and the visibility of the biliary tree and pancreatic duct on magnetic resonance (MR) cholangiopancreatographic (MRCP) images obtained with a single-breath-hold three-dimensional (3D) fast-recovery fast spin-echo (FRFSE) sequence in comparison with conventional two-dimensional (2D) single-shot fast spin-echo (SSFSE) thin-section and thick-slab sequences. MATERIALS AND METHODS: Institutional review board approval was obtained; informed consent was not required for this HIPAA-compliant study. MRCP was performed at 1.5 T in 53 consecutive patients (25 men and 28 women, aged 23-84 years). A single-breath-hold volume acquisition was performed by using the 3D FRFSE sequence and the conventional 2D SSFSE sequences. Two radiologists graded studies obtained with each sequence in a blinded fashion, and the paired Student t test was used to assess differences in technical quality, visibility of eight individual ductal segments of the biliary tree and pancreatic duct, and number of ductal segments visualized per patient. RESULTS: Studies obtained with 3D FRFSE were of significantly higher technical quality than those obtained with thin-section 2D SSFSE (P < .02 for both readers). The 3D FRFSE maximum intensity projection reconstruction and 2D SSFSE thick-slab sequence proved statistically equivalent with regard to the overall visibility of the biliary tree and pancreatic duct and the number of ductal segments visualized per patient. In comparison with 2D SSFSE thin-section imaging, however, 3D FRFSE imaging produced an improved overall duct segment visibility grade of 0.45 on a three-point visibility scale (P < .001), with a corresponding average per-patient improvement of 1.9 out of eight possible fully visualized duct segments (P < .001). CONCLUSION: The 3D FRFSE sequence shows promise for improved visibility of the pancreatic duct and biliary tree, compared with the conventional 2D SSFSE thin-section and thick-slab approach, while permitting the entire MRCP examination to be performed in a single breath hold.

Adult↗
PubMed2005

State-of-the-art computed tomographic and magnetic resonance imaging of the gastrointestinal system.

Among the major innovations in radiology of the gastrointestinal (GI) system are the replacement of classic invasive diagnostic methods with noninvasive ones and the improvement in lesion characterization and staging of pancreatobiliary malignancies. Developments in imaging technology have led to many improvements in the field of diagnostic GI radiology. With its fast and thin-section scanning abilities, multidetector-row CT (MDCT) strengthens the place of CT as the most efficient tool to diagnose, characterize, and preoperatively stage pancreatic neoplasms. MR cholangiopancreatography has widely replaced endoscopic retrograde cholangiopancreatography in the diagnosis and staging of pancreatobiliary malignancies. MR imaging, using phased-array or endorectal coils, demonstrates local tumor invasion accurately in rectal cancers and thus allows an improved surgical planning. Virtual colonoscopy with MDCTs is an efficient screening method for colon cancer, and MDCT enterography is becoming the standard imaging technique for many small bowel disorders. The continuing developments in CT and MR technology will most probably further improve the accuracy of these and other imaging applications in the near future.

Gastrointestinal Diseases↗
PubMed2005

Multislice CT colonography: current status and limitations.

CT colonography (CTC) is a promising method for colorectal cancer screening because it provides a full structural evaluation of the entire colon. It has a superior safety profile, a low rate of complications, and high patient acceptance. In addition, CTC offers the real possibility of eliminating the cathartic bowel preparation, one of the biggest obstacles to patient compliance with colorectal cancer screening. Results of CTC studies in recently published literature are extremely encouraging, demonstrating that this method of screening can detect lesions equal to or larger than 8 mm with few false-positive findings.

Colonic Diseases↗
PubMed2005

Consensus on current clinical practice of virtual colonoscopy.

OBJECTIVE: The purpose of our study was to determine the current opinions regarding the performance, interpretation, reporting, and clinical role of virtual colonoscopy among a group of selected experts to develop a consensus statement. MATERIALS AND METHODS: A questionnaire was sent to 33 selected experts in virtual colonoscopy. Responses were tabulated and results were used to develop a consensus statement. The results of the questionnaire and consensus statement were sent to respondents for comment and approval. RESULTS: Thirty-one (93.9%) of 33 surveys were returned. Eighty-seven percent (27/31) of respondents believe virtual colonoscopy is a credible screening method. Oral sodium phosphate solution is the laxative preferred by more than 66% (18/27), whereas 62% (13/21) do not believe fecal tagging is necessary. All respondents (25/25) think that both prone and supine imaging is required, with most (81%, 21/26) believing IV contrast material is not necessary. The routine use of spasmolytics is suggested by only 15% (4/26). The largest acceptable slice thickness of 3 mm is agreed on by 88% (22/25). All respondents believe screening virtual colonoscopy should be performed at a lower dose per slice than conventional CT. Most (80%, 20/25) believe the optimum method of interpreting virtual colonoscopy should be primary axial review, with 3D used for problem solving. All but one respondent (96%, 26/27) agree there is a threshold size below which polyps are not clinically important. When reporting virtual colonoscopy results, 59% (16/27) believe polyps less than 4 mm need not be reported. CONCLUSION: A consensus is developing among experts as to the appropriate manner in which virtual colonoscopy should be performed, interpreted, and reported.

Colonography, Computed Tomographic↗
PubMed2003

Computerized tomographic colonography: performance evaluation in a retrospective multicenter setting.

BACKGROUND & AIMS: No multicenter study has been reported evaluating the performance and interobserver variability of computerized tomographic colonography. The aim of this study was to assess the accuracy of computerized tomographic colonography for detecting clinically important colorectal neoplasia (polyps >or=10 mm in diameter) in a multi-institutional study. METHODS: A retrospective study was developed from 341 patients who had computerized tomographic colonography and colonoscopy among 8 medical centers. Colonoscopy and pathology reports provided the standard. A random sample of 117 patients, stratified by criterion standard, was requested. Ninety-three patients were included (47% with polyps >or=10 mm; mean age, 62 years; 56% men; 84% white; 40% reported colorectal symptoms; 74% at increased risk for colorectal cancer). Eighteen radiologists blinded to the criterion standard interpreted computerized tomography colonography examinations, each using 2 of 3 different software display platforms. RESULTS: The average area under the receiver operating characteristic curve for identifying patients with at least 1 lesion >or=10 mm was 0.80 (95% lower confidence bound, 0.74). The average sensitivity and specificity were 75% (95% lower confidence bound, 68%) and 73% (95% lower confidence bound, 66%), respectively. Per-polyp sensitivity was 75%. A trend was observed for better performance with more observer experience. There was no difference in performance across software display platforms. CONCLUSIONS: Computerized tomographic colonography performance compared favorably with reported performance of fecal occult blood testing, flexible sigmoidoscopy, and barium enema. A prospective study evaluating the performance of computerized tomography colonography in a screening population is indicated.

Colonic Neoplasms↗
PubMed2003

Multislice CT colonography: current status and limitations.

CT colonography (CTC) is a promising method for colorectal screening providing a full structural evaluation of the entire colon and gaining in popularity due to a superior safety profile, a low rate of complications, and high patient acceptance. Multislice CT (MSCT) has further improved the diagnostic potential of CTC by generating high-resolution CT images of the abdomen and pelvis in shorter acquisition times than was previously possible. Over the past year, multiple studies have been published on every aspect of CTC including techniques, image display, image reconstruction, and clinical trial results assessing the feasibility of CTC as a screening tool. Yet despite increasing clinical use, the appropriate role of CTC in colorectal cancer screening remains undefined and barriers to widespread adoption remain. In particular, though the test is generally regarded as easy to perform, accurate interpretation requires a steep learning curve. While several large studies have found high sensitivity and specificity, the accuracy of CTC in a screening population has yet to be verified and almost no health insurance plans reimburse for its use in colorectal screening. Ongoing research in computer-aided detection and new software tools, however, have the potential to increase accuracy and ease of interpretation significantly, accelerating its acceptance as a colorectal screening tool.

Colon↗
PubMedDate not supplied

Amyloidosis: review and CT manifestations.

Amyloidosis is a collection of disease entities that produce considerable morbidity and mortality and are increasing in prevalence. The imaging findings are problematically nonspecific and diverse. This lack of specificity is compounded by the fact that amyloidosis is strongly associated with and frequently coexists with many other chronic disease states that have their own imaging findings. Amyloidosis can involve any organ singly or in conjunction with other organs and can do so in the form of a focal, tumorlike lesion or an infiltrative process. In the proper clinical setting, that is, in a patient with chronic inflammatory disease and especially in a patient with multiple myeloma, amyloidosis should be considered as a possible cause of worsening or new symptoms or imaging findings. Occasionally, the radiologic findings may precede the clinical findings, thus providing the radiologist with the opportunity to contribute to the patient's care. However, to make a difference in patient care, the radiologist must be familiar with the diverse imaging findings of amyloidosis as well as the patient's clinical history, which could raise the suspicion of amyloidosis.

Aged↗