Titel Deelnemers "Korte inhoud" "Magnetic resonance imaging: value of diffusion-weighted imaging in differentiating benign from malignant breast lesions" "Sandra Stijven, Ellen GIELEN, Charlotte Bevernage, Monique HORVATH, Liesbeth MEYLAERTS" "Objectives: Although magnetic resonance imaging (MRI) has a high sensitivity in the detection of tumours, there is still much discussion about its role in breast cancer detection. MRI is not yet routinely used to further characterize lesions in patients diagnosed with breast cancer. This study investigated the impact of preoperative MRI on the surgical treatment of women with biopsy proven breast cancer. The diagnostic value of preoperative MRI was compared with that of conventional imaging (mammography and ultrasonography), and the diffusion-weighted imaging technique was also evaluated. Study design: 40 women underwent conventional imaging and biopsy as part of the clinical workup. In addition, preoperative MRI was performed in each patient. The kinetics of contrast captation were monitored and apparent diffusion coefficients were calculated. All imaging findings were compared with the histopathologic results, which were used as the gold standard. Differences in tumour extent, as determined by ultrasonography, MRI and histopathology, were evaluated. Results: Contrast captation kinetics curves are mostly aspecific, while apparent diffusion coefficient values seem to correlate much better with tumour malignancy. MRI correlated more accurately with histopathological findings than ultrasonography and even revealed unsuspected multifocal and multicentric breast carcinoma in 20 patients (50%). The surgical plan of seven patients (18%) was changed as a result of the additional information provided by MRI. Conclusion: Diffusion-weighted imaging as a complementary tool to contrast captation kinetics and morphologic measurements may increase the specificity of MRI and help in differentiating between benign and malignant breast lesions. In addition, MRI yields more precise information than mammography and ultrasonography about the exact location, the extent, the multifocality or multicentricity of the tumour and can also detect possible additional tumours. Although MRI will never replace mammography (screening) or ultrasonography as a test for breast cancer in women with no high risk (e.g. BRCA 1 or 2 carriers), its use in a preoperative setting may allow more accurate staging of the disease, which in turn could result in a change in the treatment planning. (C) 2012 Elsevier Ireland Ltd. All rights reserved." "Correspondence-Aware Manifold Learning for Microscopic and Spatial Omics Imaging: A Novel Data Fusion Method Bringing Mass Spectrometry Imaging to a Cellular Resolution." "Tina Smets, Thomas Tousseyn, Etienne Waelkens, Bart De Moor" "High-dimensional molecular measurements are transforming the field of pathology into a data-driven discipline. While hematoxylin and eosin (H&E) stainings are still the gold standard to diagnose diseases, the integration of microscopic and molecular information is becoming crucial to advance our understanding of tissue heterogeneity. To this end, we propose a data fusion method that integrates spatial omics and microscopic data obtained from the same tissue slide. Through correspondence-aware manifold learning, we can visualize the biological trends observed in the high-dimensional omics data at microscopic resolution. While data fusion enables the detection of elements that would not be detected taking into account the separate data modalities individually, out-of-sample prediction makes it possible to predict molecular trends outside of the measured tissue area. The proposed dimensionality reduction-based data fusion paradigm will therefore be helpful in deciphering molecular heterogeneity by bringing molecular measurements such as mass spectrometry imaging (MSI) to the cellular resolution." "Imaging depth variations in hyperspectral imaging: Development of a method to detect tumor up to the required tumor‐free margin width" "Esther Kho, Lisanne L. Boer, Anouk L. Post, Koen Van de Vijver, Katarzyna Józwiak, Henricus J.C.M. Sterenborg, Theo J.M. Ruers" "Hyperspectral imaging is a promising technique for resection margin assessment during cancer surgery. Thereby, only a specific amount of the tissue below the resection surface, the clinically defined margin width, should be assessed. Since the imaging depth of hyperspectral imaging varies with wavelength and tissue composition, this can have consequences for the clinical use of hyperspectral imaging as margin assessment technique. In this study, a method was developed that allows for hyperspectral analysis of resection margins in breast cancer. This method uses the spectral slope of the diffuse reflectance spectrum at wavelength regions where the imaging depth in tumor and healthy tissue is equal. Thereby, tumor can be discriminated from healthy breast tissue while imaging up to a similar depth as the required tumor-free margin width of 2 mm. Applying this method to hyperspectral images acquired during surgery would allow for robust margin assessment of resected specimens. In this paper, we focused on breast cancer, but the same approach can be applied to develop a method for other types of cancer." "Intracranial Vessel Wall Imaging with Magnetic Resonance Imaging: Current Techniques and Applications" "Vincent Thijs" "Vessel wall magnetic resonance imaging (VW-MRI) is a modern imaging technique with expanding applications in the characterization of intracranial vessel wall pathology. VW-MRI provides added diagnostic capacity compared with conventional luminal imaging methods. This review explores the principles of VW-MRI and typical imaging features of various vessel wall pathologies, such as atherosclerosis, dissection, and vasculitis. Radiologists should be familiar with this important imaging technique, given its increasing use and future relevance to everyday practice." "The appropriate and justified use of medical radiation in cardiovascular imaging: a position document of the ESC Associations of Cardiovascular Imaging, Percutaneous Cardiovascular Interventions and Electrophysiology" "HEIN Heidbüchel" "The benefits of cardiac imaging are immense, and modern medicine requires the extensive and versatile use of a variety of cardiac imaging techniques. Cardiologists are responsible for a large part of the radiation exposures every person gets per year from all medical sources. Therefore, they have a particular responsibility to avoid unjustified and non-optimized use of radiation, but sometimes are imperfectly aware of the radiological dose of the examination they prescribe or practice. This position paper aims to summarize the current knowledge on radiation effective doses (and risks) related to cardiac imaging procedures. We have reviewed the literature on radiation doses, which can range from the equivalent of 1-60 milliSievert (mSv) around a reference dose average of 15 mSv (corresponding to 750 chest X-rays) for a percutaneous coronary intervention, a cardiac radiofrequency ablation, a multidetector coronary angiography, or a myocardial perfusion imaging scintigraphy. We provide a European perspective on the best way to play an active role in implementing into clinical practice the key principle of radiation protection that: 'each patient should get the right imaging exam, at the right time, with the right radiation dose'." "Triplane tissue Doppler imaging: a novel three-dimensional imaging modality that predicts reverse left ventricular remodelling after cardiac resynchronisation therapy" "Nico Van De Veire, Nina Ajmone Marsan, Gabe B. Bleeker, Johan De Sutter" "Background: Several two-dimensional (2-D) tissue Doppler imaging (TDI) echocardiographic techniques have proved useful to identify responders to cardiac resynchronisation therapy (CRT). Recently a 3-D probe allowing simultaneous acquisition of TDI data in three imaging planes became available. Objective: To evaluate the value of triplane TDI to predict reverse left ventricular (LV) remodelling after CRT. Methods: Sixty patients with heart failure, scheduled for CRT, underwent triplane echocardiography with simultaneous TDI acquisition before and 6 months after implantation. From the triplane dataset a 3-D LV volume was generated and LV volumes and ejection fraction were calculated. Intraventricular dyssynchrony was quantitatively analysed by evaluating time from onset of the QRS complex to peak myocardial systolic velocity in 12 LV segments from the triplane dataset and calculation of the standard deviation (Ts-SD-12). Clinical response was defined as an improvement of at least one New York Heart Association class. Reverse LV remodelling was defined as >= 15% decrease of LV end-systolic volume at 6 months' follow-up. Results: Responders to CRT had significantly more LV dyssynchrony at baseline than non-responders (mean (SD) Ts-SD- 12: 42 (14) vs 22 (12), p" "Triplane tissue Doppler imaging: a novel three-dimensional imaging modality that predicts reverse left ventricular remodelling after cardiac resynchronisation therapy" "Nico Van de Veire, CM Yu, N Ajmone-Marsan, GB Bleeker, C Ypenburg, Q Zhang, JHW Fung, JYS Chan, ER Holman, EE van der Wall, MJ Schalij, JJ Bax" "Background: Several two-dimensional (2-D) tissue Doppler imaging (TDI) echocardiographic techniques have proved useful to identify responders to cardiac resynchronisation therapy (CRT). Recently a 3-D probe allowing simultaneous acquisition of TDI data in three imaging planes became available. Objective: To evaluate the value of triplane TDI to predict reverse left ventricular (LV) remodelling after CRT. Methods: Sixty patients with heart failure, scheduled for CRT, underwent triplane echocardiography with simultaneous TDI acquisition before and 6 months after implantation. From the triplane dataset a 3-D LV volume was generated and LV volumes and ejection fraction were calculated. Intraventricular dyssynchrony was quantitatively analysed by evaluating time from onset of the QRS complex to peak myocardial systolic velocity in 12 LV segments from the triplane dataset and calculation of the standard deviation (Ts-SD-12). Clinical response was defined as an improvement of at least one New York Heart Association class. Reverse LV remodelling was defined as >= 15% decrease of LV end-systolic volume at 6 months' follow-up. Results: Responders to CRT had significantly more LV dyssynchrony at baseline than non-responders (mean (SD) Ts-SD- 12: 42 (14) vs 22 (12), p< 0.001). A cut-off value of 33 ms for baseline Ts-SD-12, acquired from the triplane TDI dataset, yielded a sensitivity of 89% with a specificity of 82% to predict clinical response to CRT; sensitivity and specificity to predict reverse LV remodelling were 90% and 83%, respectively. Conclusion: Triplane TDI echocardiography predicts clinical response and reverse LV remodelling 6 months after CRT implantation." "Imaging in patients with cardiovascular implantable electronic devices: part 2-imaging after device implantation. A clinical consensus statement of the European Association of Cardiovascular Imaging (EACVI) and the European Heart Rhythm Association (EHRA)" "Jens-Uwe Voigt" "Cardiac implantable electronic devices (CIEDs) improve quality of life and prolong survival, but there are additional considerations for cardiovascular imaging after implantation-both for standard indications and for diagnosing and guiding management of device-related complications. This clinical consensus statement (part 2) from the European Association of Cardiovascular Imaging, in collaboration with the European Heart Rhythm Association, provides comprehensive, up-to-date, and evidence-based guidance to cardiologists, cardiac imagers, and pacing specialists regarding the use of imaging in patients after implantation of conventional pacemakers, cardioverter defibrillators, and cardiac resynchronization therapy (CRT) devices. The document summarizes the existing evidence regarding the role and optimal use of various cardiac imaging modalities in patients with suspected CIED-related complications and also discusses CRT optimization, the safety of magnetic resonance imaging in CIED carriers, and describes the role of chest radiography in assessing CIED type, position, and complications. The role of imaging before and during CIED implantation is discussed in a companion document (part 1)." "Imaging in patients with cardiovascular implantable electronic devices: part 1-imaging before and during device implantation. A clinical consensus statement of the European Association of Cardiovascular Imaging (EACVI) and the European Heart Rhythm Associ" "Jens-Uwe Voigt" "More than 500 000 cardiovascular implantable electronic devices (CIEDs) are implanted in the European Society of Cardiology countries each year. The role of cardiovascular imaging in patients being considered for CIED is distinctly different from imaging in CIED recipients. In the former group, imaging can help identify specific or potentially reversible causes of heart block, the underlying tissue characteristics associated with malignant arrhythmias, and the mechanical consequences of conduction delays and can also aid challenging lead placements. On the other hand, cardiovascular imaging is required in CIED recipients for standard indications and to assess the response to device implantation, to diagnose immediate and delayed complications after implantation, and to guide device optimization. The present clinical consensus statement (Part 1) from the European Association of Cardiovascular Imaging, in collaboration with the European Heart Rhythm Association, provides comprehensive, up-to-date, and evidence-based guidance to cardiologists, cardiac imagers, and pacing specialists regarding the use of imaging in patients undergoing implantation of conventional pacemakers, cardioverter defibrillators, and resynchronization therapy devices. The document summarizes the existing evidence regarding the use of imaging in patient selection and during the implantation procedure and also underlines gaps in evidence in the field. The role of imaging after CIED implantation is discussed in the second document (Part 2)." "Perspectives of Novel Imaging Techniques for Staging, Therapy Response Assessment, and Monitoring of Surveillance in Lung Cancer Summary of the Dresden 2013 Post WCLC-IASLC State-of-the-Art Imaging Workshop" "Johan Vansteenkiste" "Modern imaging techniques that can provide functional information on tumor vascularization, metabolic activity, or cellularity have seen significant improvements over the past decade. However, most of these techniques are currently not broadly utilized neither in clinical trials nor in clinical routine, although there is a large agreement on the fact that conventional approaches for therapy response assessment such as Response Evaluation Criteria in Solid Tumors or World Health Organization criteria-that exclusively focus on the change in tumor size-are of less value for response assessment in modern thoracic oncology. The aim of this article comprises two parts: a short review of the most promising state-of-the-art imaging techniques that have the potential to play a larger role in thoracic oncology within the near future followed by a meeting report including recommendations of an interdisciplinary expert panel that discussed the potential of the different techniques during the Dresden 2013 Post World Congress of Lung Cancer (WCLC)--International Association for the Study of Lung Cancer (IASLC) meeting. It is intended to provide a comprehensive summary about ongoing trends and future perspectives on functional imaging in thoracic oncology."