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Titolo:
Hepatic tumor imaging using iron oxide MRI: Comparison with computed tomography, clinical impact, and cost analysis
Autore:
Schultz, JF; Bell, JD; Goldstein, RM; Kuhn, JA; McCarty, TM;
Indirizzi:
Baylor Univ, Med Ctr, Dept Surg, Dallas, TX 75246 USA Baylor Univ Dallas TX USA 75246 Med Ctr, Dept Surg, Dallas, TX 75246 USA
Titolo Testata:
ANNALS OF SURGICAL ONCOLOGY
fascicolo: 7, volume: 6, anno: 1999,
pagine: 691 - 698
SICI:
1068-9265(199910/11)6:7<691:HTIUIO>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONTRAST-ENHANCED CT; ARTERIAL PORTOGRAPHY; SPIRAL-CT; COMPARATIVE SENSITIVITIES; MAGNETIC-RESONANCE; FERRITE PARTICLES; LIVER METASTASES; DELAYED CT; HELICAL CT; AGENT;
Keywords:
hepatic neoplasms; iron oxide MRI;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: McCarty, TM Baylor Univ, Med Ctr, Dept Surg, 3500 Gaston Ave, Dallas, TX 75246 USA Baylor Univ 3500 Gaston Ave Dallas TX USA 75246 , TX 75246 USA
Citazione:
J.F. Schultz et al., "Hepatic tumor imaging using iron oxide MRI: Comparison with computed tomography, clinical impact, and cost analysis", ANN SURG O, 6(7), 1999, pp. 691-698

Abstract

Background: The surgical management of hepatic tumors has traditionally relied on preoperative contrast-enhanced computed tomography (CECT) in combination with intraoperative ultrasonography (IOUS). Unfortunately, the ability to detect and characterize hepatic tumors by using CECT is limited, and IOUS frequently reveals additional disease that alters the operative approach. Recent advances in hepatic magnetic resonance imaging (MRI) may improve preoperative tumor detection and characterization; however, little is knownabout how MRI compares with CECT or about the clinical impact and cost considerations of liver MRI. Methods: A retrospective chart review was performed to compare iron oxide (Feridex [Fe])-MRI with CECT in the preoperative imaging of hepatic neoplasms, eis well as to determine the clinical impact and overall healthcare costs associated with Fe-MRI. Results: Of approximately 1000 patients who underwent abdominal MRI at a single institution during a 20-month period, 57 were identified who underwent Fe-MRI evaluation of the liver. Indications for imaging included suspected metastases (n = 43), an indeterminate hepatic mass (n = 9), or primary hepatic cancer (n = 5). Overall, Fe-MRI identified a total of 157 lesions (mean, 2.75 per patient; range, 0-14). CECT was performed in SO patients, of whom 35 had primary or metastatic cancer. Fe-MRI identified more lesions than CT (n = 136 vs. 77; P = .016), and the average size of lesion detected byIie-MRI was significantly smaller than that by CECT (2.5 vs. 3.4 cm; P = .018). Comparison of CECT and I;e-MRI findings with IOUS and pathological specimens showed a significant difference in sensitivity (MRI, 86%; CECT, 58%; P < .001), and IOUS changed the operative approach in only 5% of those imaged with Fe-MRT. Overall, Fe-MRI altered the clinical management in 67% ofpatients imaged (n = 38 of 57), which corresponded to an overall net cost savings of $108,368 ($1,901 per patient). Conclusions: Fe-MRI is a powerful imaging technique, with greater hepatic tumor detection sensitivity than CECT. Moreover, it is an economically feasible imaging method that will alter the clinical management in most patients imaged.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/07/20 alle ore 09:34:50