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PubMed1998

[Relationship between imaging and pathological features and clinical factors in surgical cases of temporal lobe epilepsy].

The relationships between imaging, pathology and presumed causes in surgical cases of temporal lobe epilepsy (TLE) was studied. The subject was 62 patients (33 males and 29 females) who had had no attacks for more than one year after surgery. Average age at surgery was 28.2 +/- 9.9 years. Obvious neurological abnormalities were not found in these cases. MRI, PET and SPECT were performed. Hematoxylin and eosin was used for pathological judgement. Their medical charts were used to investigate their clinical factors. Although patients suspected of having encephalitis/meningitis had been hospitalized for 2 days to three months during childhood due to disturbance of consciousness with high fever and convulsion for several days; they were not diagnosed with encephalitis/meningitis at that time, and they suffered almost no handicaps other than epilepsy for several years following their comatose episodes. [Result] (1) On MRI, mesial temporal sclerosis (MTS) was detected in 48 of 52 patients (92%); 32 (62%) had high-signal intensity on T 2-weighted images; 31 (60%) had atrophy ¿23 (44%) had high-signal intensity on T 2 + atrophy¿; 5 (10%) had calcified lesions; and 2 (4%) had cystic lesions. On PET and SPECT, abnormal cerebral blood flow was noted in 33 of 36 (92%). (2) On pathological findings (61 cases), Ammon's horn sclerosis (AHS), tumors, gliosis in lateral temporal and meningeal inflammatory finding were detected in 42 (69%), 10 (23%) and 8 (13%) cases, respectively, whereas 2 showed no abnormalities. The 2 patients with normal pathology showed both high-signal intensity and atrophy on MRI. (3) The presumed causes of TLE were encephalitis/meningitis and/or suspected of these diseases in 15 patients (24%), injuries at birth in 5 (8%), and none in 42 (68%). The presumed causes in the 43 patients with AHS were encephalitis/meningitis in 11, injuries at birth in 3, and none in 29. Of the 15 patients in whom encephalitis/meningitis was estimated as the causes of TLE, only 6 (40%) had pathological evidence of meningeal inflammatory finding. Of the 42 patients in whom cause could not be determined, 2 had pathological evidence of meningeal inflammatory finding.

Adolescent↗
PubMed2003

Digital imaging applications in anatomic pathology.

Digital imaging has progressed at a rapid rate and is likely to eventually replace chemical photography in most areas of professional and amateur digital image acquisition. In pathology, digital microscopy has implications beyond that of taking a photograph. The arguments for adopting this new medium are compelling, and given similar developments in other areas of pathology and radiologic imaging, acceptance of the digital medium should be viewed as a component of the technological evolution of the laboratory. A digital image may be stored, replicated, catalogued, employed for educational purposes, transmitted for further interpretation (telepathology), analyzed for salient features (medical vision/image analysis), or form part of a wider digital healthcare strategy. Despite advances in digital camera technology, good image acquisition still requires good microscope optics and the correct calibration of all system components, something which many neglect. The future of digital imaging in pathology is very promising and new applications in the fields of automated quantification and interpretation are likely to have profound long-term influence on the practice of anatomic pathology. This paper discusses the state of the art of digital imaging in anatomic pathology.

Education, Medical↗
PubMed1994

Primary liver neoplasms: MR imaging with pathologic correlation.

Magnetic resonance (MR) imaging is a powerful tool in the evaluation of primary liver neoplasms. Determination of tumor extent and tissue characterization is provided with standard spin-echo T1- and T2-weighted imaging and is enhanced by the application of advanced sequences such as gradient-echo, fast spin-echo, and fat suppression techniques. Intravenously administered contrast agents, such as gadopentetate dimeglumine and superparamagnetic iron oxide, provide additional opportunities for lesion characterization. Knowledge of the underlying gross and microscopic pathologic features of primary hepatic neoplasms leads to a better understanding of their often complicated MR imaging appearances. The authors correlate the key pathologic features with the most significant MR imaging findings of primary benign and malignant liver neoplasms, including hemangioma, focal nodular hyperplasia, hepatocellular adenoma, infantile hemangioendothelioma, mesenchymal hamartoma, hepatocellular carcinoma, fibrolamellar carcinoma, intrahepatic cholangiocarcinoma, biliary cystadenoma and cystadenocarcinoma, angiosarcoma, hepatoblastoma, and undifferentiated embryonal sarcoma.

Adenoma, Liver Cell↗
PubMed2006

Clinical, imaging, and pathological characteristics of left ventricular thrombus: a comparison of contrast-enhanced magnetic resonance imaging, transthoracic echocardiography, and transesophageal echocardiography with surgical or pathological validation.

BACKGROUND: Left ventricular (LV) thrombus is a frequent and potentially dangerous complication of ischemic heart disease (IHD). We evaluated the clinical, imaging, and pathology characteristics of confirmed LV thrombus and compared the diagnostic value of contrast-enhanced magnetic resonance imaging (MRI) with transthoracic (TTE) and transesophageal echocardiography (TEE) for the diagnosis of LV thrombi. METHODS: Between November 1997 and December 2003, 361 patients with IHD had surgical and/or pathological confirmation of presence or absence of LV thrombus. Clinical information and preoperative imaging study reports were retrospectively reviewed regarding detection of thrombus. Comparisons were made between clinical and imaging characteristics of patients with and without confirmed thrombus. RESULTS: Left ventricular thrombus was present in 106 (29%) of 361 patients in this study. Patients with thrombus had a higher incidence of recent embolic events (6.1% vs 0.8%, P < .005). In 160 patients with all 3 imaging modalities performed within 30 days of surgical or pathological confirmation, contrast-enhanced MRI showed the highest sensitivity and specificity (88% +/- 9% and 99% +/- 2%, respectively) compared with TTE (23% +/- 12% and 96% +/- 3.6%, respectively) and TEE (40% +/- 14% and 96% +/- 3.6%, respectively) for thrombus detection. CONCLUSIONS: Left ventricular thrombus occurs frequently in patients with IHD and is associated with risk of systemic embolization. Contrast-enhanced MRI provided the highest sensitivity and specificity for LV thrombus when compared to TTE and TEE, and should be considered in the care of patients at high risk of LV thrombus formation.

Aged↗
PubMed1995

DNA ploidy status in 84 ocular melanomas: a study of DNA quantitation in ocular melanomas by flow cytometry and automatic and interactive static image analysis.

Deoxyribonucleic acid (DNA) ploidy was quantified in 84 ocular melanomas (median follow-up, 11-years) by flow cytometry, CAS 200 interactive image analysis, and Pathology Image Processing Environment (PIPE; Department of Quantitative Pathology, Free University, Amsterdam, The Netherlands) automatic image analysis (75). Overall, 32.1% of the melanomas were aneuploid, 2.3% were tetraploid, and 66.6% were diploid. Pathology Image Processing Environment analysis estimated DNA ploidy in 12 tumors that were unprocessable by flow cytometry. Of 10 tumors that were diploid by flow cytometry, PIPE detected stemline aneuploidy in five and some aneuploid cells in five more. Seven tumors were aneuploid by PIPE but diploid by CAS 200, five of which contained occasional DNA aneuploid cells on the CAS 200 histograms. Pathology Image Processing Environment analysis quantified tumor samples with an average of 500 (250 to 1,050) cells in less than 10 minutes. All cells classified as spindle A according to the Callender system (more than 10,000) were diploid. Spindle B and epithelioid cells occupied both diploid and aneuploid peaks on the DNA histograms. Dioxyribonucleic acid variables did not correlate with established prognosticators, such as Callender cell type, largest tumor dimension, or glaucoma, nor did they reach significance by univariate and multivariate analyses. The value of these findings as a diagnostic support in uveal melanoma, particularly in combination with fine needle aspiration biopsy, is discussed.

DNA, Neoplasm↗
PubMed1992

Chondrosarcoma: MR imaging with pathologic correlation.

Magnetic resonance (MR) images of 21 surgically confirmed chondrosarcomas were retrospectively reviewed in conjunction with plain radiographs and computed tomographic scans and correlated with pathologic findings. The tumors appeared lobulated, and signal intensity, as analyzed visually (intermediate on T1-weighted, high on T2-weighted images), was similar for all lesions, regardless of pathologic type. Size of lesion was not an indicator of grade. The appearances of mesenchymal and dedifferentiated chondrosarcomas mimicked that of conventional chondrosarcoma. Extraskeletal chondrosarcoma was visualized as a lobulated soft-tissue mass. In all cases, MR imaging accurately depicted intraosseous and soft-tissue extent of tumor noted at surgery and pathologic examination. Histologic type or grade of chondrosarcoma generally cannot be characterized on the basis of visual analysis of signal intensity noted on routine MR images. However, MR imaging is excellent for exact delineation of tumor extent.

Bone Neoplasms↗
PubMed2005

[Correlation between pathology and image characteristics of retroperitoneal liposarcoma].

OBJECTIVE: To investigate the correlation between the pathological and image features of different subtypes of retroperitoneal liposarcoma. METHODS: Pathological and image characteristics of 21 retroperitoneal liposarcomas were retrospectively analyzed comparing their different histopathological subtypes. RESULTS: This series consisted of 11 well-differentiated, 4 myxoid, 3 round-cell, 2 pleomorphic and 1 dedifferentiated liposarcoma. Well-differentiated liposarcomas were predominantly composed of lipoma-like and sclerosing components. On CT and MRI image, the attenuation and signal intensity of lipoma-like components resembled those of fat, whereas the signal intensity of sclerosing components was similar to those of muscle. Unenhanced CT image of the myxoid subtype showed density resembling that of water. On contrast-enhanced CT image, it showed gradual reticular or sheet-like enhancement. The CT and MRI image appearance of the round cell and pleomorphic subtypes resembled those of nonfatty soft tissue masses with foci of necrosis. The dedifferentiated liposarcoma showed the image feature of a well-differentiated component clearing enhanced soft tissue mass. CONCLUSION: Different subtypes of retroperitoneal liposarcoma show different CT and MRI features relating to their major histologic components. A good understanding of the relation between their radiological and pathological features is helpful to arrive at a correct diagnosis for retroperitoneal liposarcoma.

Adult↗
PubMedDate not supplied

Pancreatic neoplasms: MR imaging and pathologic correlation.

Magnetic resonance (MR) imaging can aid in the detection and characterization of many pancreatic neoplasms. The MR imaging appearances of common pancreatic neoplasms such as ductal adenocarcinoma are well-known. However, MR imaging features of more unusual pancreatic neoplasms are not well understood. Such tumors include mucin-hyper-secreting carcinoma, serous microcystic neoplasm, mucinous macrocystic neoplasm, solid and papillary epithelial neoplasm, multiple cysts associated with von Hippel-Lindau disease, acinar cell carcinoma, pancreaticoblastoma, and endocrine neoplasms (eg, nonfunctioning islet cell tumors, insulinoma, and gastrinoma). In general, pancreatic neoplasms demonstrate high signal intensity on T2-weighted images; the signal intensity on T1-weighted images is more variable but is often intermediate or low. Gadolinium enhancement is often helpful in further characterizing pancreatic neoplasms. The gross and histologic features of pancreatic neoplasms are also not well-known. Correlation with the underlying pathologic features enhances understanding of the MR imaging characteristics of both common and unusual pancreatic neoplasms.

Adenocarcinoma, Mucinous↗
PubMed1990

Hypointense renal cell carcinoma: MR imaging with pathologic correlation.

In two pathologically documented cases of renal cell carcinoma, the appearance of the tumors at magnetic resonance (MR) imaging was markedly hypointense relative to normal renal parenchyma on both T1- and T2-weighted spin-echo images. Pathologic examination of both tumors revealed diffuse iron scattered throughout the tumors. The paramagnetic effect of the iron may account for this unusual hypointense appearance at spin-echo imaging, independent of pulse sequence.

Carcinoma, Renal Cell↗
PubMedDate not supplied

Molecular imaging and therapy directed at the neovasculature in pathologies. How imaging can be incorporated into vascular-targeted delivery systems to generate active therapeutic agents.

We have discussed the impact of molecular imaging on clinical and preclinical medicine. We have presented the potential problems of delivering the effective therapeutic dose and the properties that can help contribute to the drug efficacy. The rationale for the design of new antiangiogenic agents that can be used for imaging and therapy was presented. Finally, results from imaging and targeted nanoparticle based therapies were presented. In vivo imaging of angiogenic tumors using anti-alpha(v)beta3 -targeted polymerized vesicles composed of the murine antibody LM609 attached to NPs labeled with the MR contrast agent gadolinium in the V2 carcinoma model in rabbits. MRI studies using this targeted contrast agent revealed large areas of alpha(v)beta3 integrin expression in tumor-associated vasculature that conventional MRIs failed to show. Other investigators have used microemulsions conjugated to an antibody targeted against alpha(v)beta as imaging agents. These materials also show contrast enhancement of tumor vasculature undergoing angiogenesis. Other markers, such as the PECAM-1 (CD-31), VCAM-1 (CD54) and VEGF receptor (flk-1), have been shown to be upregulated on tumor endothelium and associated with angiogenesis but have not been used in imaging studies. Furthermore, by modification of the NPs, we were able to use this imaging agent as an antiangiogenic gene delivery system. The results from these studies are very promising and are being further pursued.

Angiogenesis Inhibitors↗
PubMedDate not supplied

Pancreatic tumors: diagnostic patterns by 3D gradient-echo post contrast magnetic resonance imaging with pathologic correlation.

Magnetic resonance (MR) imaging has considerable potential in characterizing pancreatic masses. Certain features can be used by the radiologist to establish a definitive diagnosis for most pancreatic tumors including ductal adenocarcinoma, islet cell tumors, solid and papillary epithelial neoplasms, micro- and macrocystic adenoma, and metastases. Recognition of these tumors on imaging is important since it often changes the treatment approach and may obviate the need for surgery. Recent introduction of 3D gradient recalled echo (GRE) sequence such as volumetric interpolated breath hold examination (VIBE) has dramatically improved MR imaging by providing dynamic enhanced thin-slice images with fat saturation and high signal-to-noise ratio. In this article, special emphasis will be placed on the impact of 3D GRE sequence in the diagnosis of pancreatic neoplasms with pathologic correlation.

Contrast Media↗
PubMed2004

Endogenous recovery of injured spinal cord: longitudinal in vivo magnetic resonance imaging.

Pathological changes were followed longitudinally with in vivo magnetic resonance imaging (MRI) and behavioral studies in experimental spinal cord injury (SCI). MRI-observed pathology was correlated with histology. On MRI, the cavitated regions of the injured cord were gradually filled with viable tissue between two and 8 weeks postinjury, and a concomitant improvement was observed in the neurobehavioral scores. By weeks 3-6, on MRI, the gray matter (GM) returned in the segments caudal, but not rostral, to the injury site. The corresponding histological sections revealed motor neurons as well as other nuclei in the gray matter immediately caudal to the epicenter, but not at the site of injury, suggesting neuronal recovery in perilesioned areas. The neuronal and neurological recovery appeared to occur about the same time as neovasculature that was reported on the contrast-enhanced MRI, suggesting a role for angiogenesis in recovery from SCI. The role of angiogenesis in neuronal recovery is further supported by the immunohistochemical observation of greater bromodeoxyuridine uptake by blood vessels near the lesion site compared with uninjured cords.

Animals↗
PubMed1999

Fibrolamellar hepatocellular carcinoma: imaging and pathologic findings in 31 recent cases.

PURPOSE: To review characteristic findings of fibrolamellar hepatocellular carcinoma (HCC) at computed tomography (CT) and magnetic resonance (MR) imaging. MATERIALS AND METHODS: The authors retrospectively reviewed the clinical, pathologic, and preoperative imaging findings in 31 patients with histologically proved fibrolamellar HCC. Dynamic contrast material-enhanced CT of the liver was performed in 31 patients, helical multiphase CT in 21, and MR imaging in 11. Complete resection was performed in 17 patients, and imaging-pathologic correlation was performed. RESULTS: Large tumors (mean diameter, 13 cm) were depicted at CT and MR in all cases. At CT, the margins of the tumors were well defined in 24 (77%) of 31 cases calcifications were depicted in 21 (68%), a central scar in 22 (71%), and abdominal lymphadenopathy in 20 (65%). In 20 (80%) of 25 cases with hepatic arterial phase CT images, all tumors were heterogeneous and depicted areas of hypervascularity. At MR imaging, tumors were hypointense to liver on T1-weighted images (n = 11) and hyperintense to liver on T2-weighted images (n = 10). Calcification was not depicted on MR images, but a central scar was depicted as hypointense to surrounding tumor in nine cases. CONCLUSION: CT and MR images demonstrate characteristic features that may allow confident diagnosis of fibrolamellar HCC.

Adolescent↗
PubMed2004

Digital imaging in pathology: theoretical and practical considerations, and applications.

Digital imaging is rapidly replacing photographic prints and Kodachromes for pathology reporting and conference purposes. Advanced systems linked to computers allow greater versatility and speed of turn-around as well as lower costs, allowing the incorporation of macroscopic and microscopic pictures into routine pathology reports and publications. Digital images allow transmission to remote sites via the Internet for primary diagnosis, consultation, quality assurance and educational purposes and can be stored and disseminated in CD-ROMs. Total slide digitisation is now a reality and has the potential to replace glass slides to a large extent. There are extensive applications of digital images in education and research, allowing more objective and automated quantitation of a variety of morphological and immunohistological parameters. Three-dimensional images of gross specimens can be developed and posted on websites for interactive educational programs and preliminary reports indicate that medical vision systems are a reality and can provide for automated computer generated histopathological diagnosis and quality assurance.

Humans↗
PubMed1992

Solid and papillary epithelial neoplasm of the pancreas: MR imaging and pathologic correlation.

Correlation of magnetic resonance (MR) imaging findings and those at pathologic evaluation was attempted in six cases of solid and papillary epithelial neoplasm of the pancreas. All patients were female, and the mean patient age was 26 years (range, 13-73 years). On T1-weighted spin-echo images, tumors were well demarcated, and areas of high signal intensity were evident within them. At macroscopic examination, these areas corresponded to solid portions with marked hemorrhagic necrosis or cystic portions filled with hemorrhagic debris. In three of four masses surrounded by macroscopically evident fibrous capsules, a rim of low intensity was revealed at T1-weighted imaging. When T1-weighted spin-echo imaging reveals obvious areas of high intensity within a sharply marginated tumor of the pancreas, especially in a young woman, solid and papillary epithelial neoplasm might be a primary diagnostic consideration.

Adolescent↗
PubMed1996

High-resolution MR imaging of stage I cervical neoplasia with a dedicated transvaginal coil: MR features and correlation of imaging and pathologic findings.

OBJECTIVE: The purposes of this study were to assess the appearance of stage 1 neoplasia of the cervix by high-resolution MR imaging with an enveloping transvaginal receiver coil and to correlate the imaging findings with the pathologic findings. SUBJECTS AND METHODS: Fifteen patients (25-73 years old; mean, 40 years old) with clinical stage I disease were examined with a 37-mm-diameter ring-design solenoid receiver coil placed around the cervix. Axial 2.5-mm contiguous slices were obtained with a field of view of 10-15 cm on a 1.0-T HPQ Vista scanner with T1-weighted (660/20 msec [TR/TE]) and T2- weighted (2500/80 msec) spin-echo sequences and dynamic gradient-echo sequences during injection of gadopentetate dimeglumine (0.1 mmol/kg). Ten patients subsequently underwent Wertheim's hysterectomy, two underwent radiotherapy, two underwent extended cone biopsy for microinvasive disease, and one underwent a punch biopsy. For seven of 10 patients who had a hysterectomy, the widths of the tumor and the residual stroma were measured at eight radial points on the transverse images and at corresponding points on the histologic specimens at 5, 10, 15, 20, and 25 mm from the ectocervix. We then compared the widths of the tumor and the stroma on images and histologic specimens at each of these 40 points. Tumor volumes were calculated from the MR imaging and pathologic data and compared. For the other three patients, detailed MR imaging-pathology correlation was not possible because of multifocal tumor distribution (two patients) and insufficient detailed pathologic data (one patient). RESULTS: Three carcinoma types were recognized. Squamous carcinoma (nine cases) was seen as a centrally expanding intermediate-signal-intensity mass, whereas oat (small)-cell carcinoma (one case) and clear-cell carcinoma (one case) showed a multifocal distribution. For patients who had a radical hysterectomy, we noted good agreement between the widths of the tumor and the stroma determined by MR imaging and histology. Tumor volumes were determined to be 0-28.2 cm3 by MR imaging and 0-18.4 cm3 by pathology. We observed tumor extension into the immediate parametrium in four patients by MR imaging; one of these cases was not confirmed at surgery. Parametrial extension was not underestimated by MR imaging in any case. CONCLUSION: High-resolution imaging of the cervix with a transvaginal coil provides accurate assessment of the intra- and extracervical extents of tumors in clinical stage 1 cervical neoplasia.

Adenocarcinoma, Clear Cell↗
PubMed1990

Overview of digital imaging in pathology. The fifth wave.

During the last decade, pathologists have witnessed dramatic advances in computer hardware and software technology. The major impact of these technologies has been in the management of text information. Significant benefits, however, lie in the manipulation and use of digital images of pathology specimens. Digital images may be analyzed to extract feature information, processed to enhance the visual image, archived to aid diagnostic efforts and education, or transmitted to facilitate communication between pathologists. These components can be integrated with information management systems to form the basis for a work-station for diagnostic pathology. Such technology will likely improve the productivity and diagnostic ability of pathologists in the coming years.

Image Processing, Computer-Assisted↗
PubMed1994

Magnetic resonance imaging and pathological analysis of a pituicytoma: case report.

A case of a pituicytoma is presented that describes the clinical, pathological, and magnetic resonance imaging features of a rare tumor of the neurohypophysis. A 26-year-old woman presented with a 4-month history of dizziness and visual obscuration. A magnetic resonance image revealed a pituitary mass with suprasellar extension. The specimen obtained from a transsphenoidal decompression identified the mass as an astrocytoma of the posterior pituitary (pituicytoma). Immunohistochemical staining was positive for glial fibrillary acidic protein, S-100, and vimentin. Electron microscopy identified intermediate filaments, numerous broad cell junctions, no secretory granules, and two cellular populations with either an electron-dense or lucent cytoplasmic matrix. This case is unique in that other documented cases originating in the posterior pituitary have all been pilocytic astrocytomas, whereas this neoplasm was not a pilocytic variant. This is also the first case in the literature of a pituicytoma documented by magnetic resonance imaging. This report reviews the cytological elements of the neurohypophysis and the origin of pituicytomas and stresses the proper use of the term "pituicytoma" in relation to tumors of the posterior pituitary.

Adult↗