没有加多基对比剂的脑瘤成像:可行还是幻想?
Ivar J H G Wamelink1, Aynur Azizova1, Thomas C Booth1
1From the Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, VUMC Site, De Boelelaan 1117, Amsterdam 1081 HV, the Netherlands (I.J.H.G.W., A.A., H.J.M.M.M., J.P., F.B., V.C.K.); Department of Imaging and Biomarkers, Cancer Center Amsterdam, Amsterdam, the Netherlands (I.J.H.G.W., A.A., H.J.M.M.M., V.C.K.); School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom (T.C.B.); Department of Neuroradiology, King's College Hospital, NHS Foundation Trust, London, UK (T.C.B.); Department of Brain Imaging, Amsterdam Neuroscience, Amsterdam, the Netherlands (H.J.M.M.M., F.B., V.C.K.); Department of Radiology, Lagos State University Teaching Hospital, Ikeja, Nigeria Radiology (A.O.); Department of Radiology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom (K.M.); Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany (J.P.); and Queen Square Institute of Neurology and Centre for Medical Image Computing, University College London, London, United Kingdom (F.B.).
在脑瘤MRI中减少基于加多的对比剂 (GBCA) 可以减少患者的负担和风险. 像替代成像序列和人工智能等策略为诊断和监测提供了有希望的替代方案.
科学领域:
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
- 医疗成像医学成像
背景情况:
- 基于加多的对比剂 (GBCA) 是初级脑瘤MRI的标准.
- 它们的使用广泛用于诊断和监测,尽管瘤分级的局限性.
- 当前的做法可能会导致不必要的GBCA暴露,影响患者的负担和资源.
研究的目的:
- 审查当前关于减少儿童和成人初级脑瘤患者GBCA暴露的策略的文献.
- 评估非对比或减少剂量的GBCA成像技术的有效性和适用性.
- 确定可降低风险并提高成本效益的成像方法.
主要方法:
- 关于脑瘤GBCA降低策略的现有研究的文献综述.
- 分析非对比增强序列 (例如动脉旋转标记) 和降低剂量的GBCA协议.
- 评估人工智能 (AI) 用于合成图像生成.
主要成果:
- 某些MRI协议,如早期手术后扫描质瘤,可能涉及GBCA使用的不确定的好处.
- 替代技术,如半剂量GBCA用于质瘤和T2加权成像用于脑膜瘤,显示了减少暴露的潜力.
- 人工智能驱动的合成成像为替代传统的依赖GBCA的方法提供了一个有希望的途径.
结论:
- 在特定的大脑瘤场景中减少GBCA的使用是可行的和有益的.
- 非对比的MRI序列和基于AI的方法为标准GBCA协议提供了可行的替代方案.
- 需要进一步的研究和临床验证才能广泛采用GBCA节约策略.
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