The contrast medium dynamics of normal and abnormal bone marrow was examined by CT.Standardised sections of lumbar vertebrae were obtained after intravenous injection of 80 ml Ultravist 370 and time-density curves of the marrow spaces were calculated in 38 patients.Time-density curves of patients with normal bone marrow differed significantly from those with proliferative bone marrow diseases in respect of maximal density and uptake at 120 and 240 seconds. Patients treated by radiation showed reduced uptake.Variations in the time-density curves between normal and abnormal bone marrow provided evidence of different perfusion and uptake of the contrast medium in the extracellular space of the bone marrow. Further investigation will be necessary to determine whether dynamic CT is able to document the effect of radiotherapy or chemotherapy on malignant bone marrow infiltration.
The MRI study within the German National Cohort, a large-scale, population-based, longitudinal study in Germany, comprises comprehensive characterization and phenotyping of a total of 30 000 participants using 3-Tesla whole-body MR imaging. A multi-centric study design was established together with dedicated core facilities for e. g. managing incidental findings or providing quality assurance. As such, the study represents a unique opportunity to substantially impact imaging-based risk stratification leading to personalized and precision medicine. Supported by the developments in the field of computational science, the newly developing scientific field of radiomics has large potential for the future. In the present article we provide an overview on population-based imaging and Radiomics and conceptualize the rationale and design of the MRI study within the German National Cohort. Key Points: • Population-based imaging and Radiomics constitute two emerging fields with great oppertunities and challenges for Radiology. • As part of the MRI-study of the NAKO approximately 30 000 subjects will undergo 3 Tesla whole-body MRI. • MR Imaging data is publicly accessable and will provide important insights into the natural history of disease processes and personalized risk profiles of the general population. Citation Format: • Schlett CL, Hendel T, Weckbach S et al. Population-Based Imaging and Radiomics: Rationale and Perspective of the German National Cohort MRI Study. Fortschr Röntgenstr 2016; 188: 652 – 661
This study analyzed temporal changes of striatal dopamine-D2 receptor binding during the course of different extrapyramidal movement disorders using 123I-iodobenzamide (IBZM) SPECT.Eighteen patients (9 with Parkinson's disease, 9 with parkinsonian plus syndrome) were followed for 11-53 mo. Dopamine-D2 receptor binding was assessed using 123I-IBZM SPECT at the beginning and at the end of the follow-up period. SPECT data were acquired 120 min postinjection of 3-5 mCi 123I-IBZM. A semiautomated algorithm was applied to the raw data for semiquantitative evaluation of regional cerebral receptor binding.Intraobserver (r = 0.992) and interobserver (r = 0.930) variance was low for the semiautomated interpretation of the SPECT examination of the dopaminergic D2 receptor binding, reflecting a highly reproducible SPECT algorithm. Mean specific dopamine-D2 receptor binding was lower in patients with parkinsonian plus syndrome compared to patients with Parkinson's disease on the initial (p < 0.001) as well as the follow-up study (p < 0.001). In patients with Parkinson's disease, we observed an unaffected receptor binding compared to a reduced binding of radiotracer in patients with parkinsonian plus syndrome during the course of the disease (p < 0.001).During the follow-up, patients with Parkinson's disease showed a constant dopamine-D2 receptor binding. In contrast, patients with parkinsonian plus syndrome revealed a decline of the binding of dopamine-D2 receptor. These findings are in agreement with histopathological data that demonstrated a preserved dopamine-D2 receptor status in patients with Parkinson's disease and a decline of the dopamine-D2 receptors in patients with parkinsonian plus syndrome. SPECT examinations using 123I-IBZM are useful for assessing dynamic changes of dopamine-D2 receptors in extrapyramidal movement disorders. Semiquantitative SPECT evaluations may provide valuable information for clinical management and prognosis of the patient with extrapyramidal movement disorders.
Personalized medicine is commonly regarded as an extension of genomic medicine. However, a personalized treatment should be based solely on the presence or absence of genetic factors. Complex imaging methods supplement the diagnostic picture of an individual patient. Comprehensive imaging in population-based settings provides information on reference intervals, the predictive value of subclinical findings, and the complex interrelationships among risk factors, subclinical imaging phenotypes, and diseases. Clinical Pharmacology & Therapeutics (2012); 92 4, 422–424. doi:10.1038/clpt.2012.100
