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Transverse greyscale ultrasound image of a soft tissue lesion in another patient with histologically proven sarcoma. The superior aspect is anechoic in keeping with necrosis with the solid inferior part of the lesion representing viable tissue. A biopsy needle is targeted into this area. Administration of gadolinium would not have been of clinical value.
Source publication
Magnetic resonance imaging has continued to evolve over the recent decades, in part, due to the evolution of gadolinium-based contrast agents and their use. These were initially thought to have a relatively low-risk profile. However, there is mounting evidence that trace amounts of gadolinium are retained within the body. To ascertain the current u...
Citations
... Furthermore, MRI can utilize contrast agents to enhance visualization in certain cases. This is particularly advantageous for detecting conditions like labral tears or tumors, where using contrast agents can improve the clarity of the images, making it easier to identify specific lesions and abnormalities [51]. ...
Shoulder joint pain is a complex and prevalent clinical concern affecting individuals across various ages and lifestyles. This review delves into the pivotal role of high-resolution imaging techniques, namely ultrasound and magnetic resonance imaging (MRI), in the comprehensive assessment and management of shoulder joint pain. We explore the anatomical foundations of the shoulder, common etiologies of pain, and the significance of precise diagnosis. High-resolution imaging facilitates the identification of various shoulder pathologies and is crucial in treatment planning, surgical interventions, and long-term prognosis assessment. We examine emerging technologies, discuss challenges and limitations, and chart potential future developments, emphasizing the ongoing evolution of imaging in this critical healthcare domain. In conclusion, high-resolution imaging is an indispensable tool, continually advancing to meet the diagnostic and therapeutic needs of individuals grappling with shoulder joint pain.
... MRI has both a high sensitivity rate (93%) and a specificity rate (97%). The sensitivity rate refers to the number of true positives (the number of people who do have cancer that will test positive for that cancer), and vice-versa the specificity test refers to the number of negatives [8]. Overall, MRIs have a high accuracy rate of 95%. ...
... Gadolinium creates perturbation or disturbance specifically to protons of water atoms creating a strong contrast hence why it is referred to as a contrast media. Despite a high sensitivity rate of 89% to 100% Gadolinium-enhanced MRI, a specificity rate varies from 46% to 88% [8]. ...
Cancer is a major problem plaguing human society today. With the research and development of nano-drug delivery technology and new non-surgical treatment methods, many types of early cancers can be cured or effectively controlled. However, the current treatment methods for advanced cancer are still limited, and efficient early cancer identification is crucial for enhancing patients prognosis and survival rates. Magnetic resonance imaging (MRI) and X-ray technologies are currently the mainstream and generally applicable means of early cancer detection. However, there is a lack of unified comparison and interpretation for their respective applicable cancer detection types. Herein, the paper first provides a comprehensive comparison and explanation of the working principles of the two technologies, as well as their advantages and disadvantages. Further, this article introduces the application of MRI and X-ray technology in the early detection of different common cancer types, including lung, breast, and brain cancers. The paper found that MRI is crucial in the early detection of brain cancer, and X-ray is a common method for lung cancer screening. With further advances in technology, cancer-related deaths can be further curbed.
... In the absence of marrow oedema or signal change on the STIR sequences, the addition of post-contrast sequences usually does not add any diagnostic value, but post-gadolinium T1 sequences can be helpful in the presence of marrow signal change. Diffusion weighted imaging can be of value in distinguishing malignant lesions from benign entities, such as in cases of pathological vertebral collapse, as it provides an indication of the lesion cellularity, with cellular lesions demonstrating increased diffusion restriction [9][10][11]. However, it can be poor at distinguishing between infection and malignancy as both these entities can show increased diffusion restriction. ...
Malignant primary vertebral tumours comprise an uncommon group of primary bone malignancies that can pose a diagnostic and therapeutic challenge. The most frequently encountered malignant primary vertebral tumours include chordoma, chondrosarcoma, Ewing sarcoma and osteosarcoma. These tumours often present with nonspecific symptoms, such as back pain, neurologic deficits and spinal instability, which can be confused for the more commonly encountered mechanical back pain and may delay their diagnosis and treatment. Imaging, including radiography, computed tomography (CT) and magnetic resonance imaging (MRI) is crucial for diagnosis, staging, treatment planning and follow-up. Surgical resection remains the mainstay of treatment for malignant primary vertebral tumours, but adjuvant radiotherapy and chemotherapy may be necessary for achieving complete tumour control depending on the type of tumour. In recent years, advances in imaging techniques and surgical approaches, such as en-bloc resection and spinal reconstruction, have improved the outcomes for patients with malignant primary vertebral tumours. However, the management can be complex due to the anatomy involved and the high morbidity and mortality associated with surgery. The different types of malignant primary vertebral lesions will be discussed in this article with an emphasis on the imaging features.
... In the absence of marrow oedema or signal change on the STIR sequences, the addition of post-contrast sequences usually does not add any diagnostic value, but post-gadolinium T1 sequences can be helpful in the presence of marrow signal change. Diffusion weighted imaging can be of value in distinguishing malignant lesions from benign entities, such as in cases of pathological vertebral collapse, as it provides an indication of the lesion cellularity, with cellular lesions demonstrating increased diffusion restriction [9][10][11]. However, it can be poor at distinguishing between infection and malignancy as both these entities can show increased diffusion restriction. ...
... Gadolinium is biologically inert and can be eliminated by urine excretion. Additionally, gadolinium promotes the osseointegration process by aiding the hydroxyapatite formation in bone-implant [19,20]. ...
The distinguished corrosion behaviour along with the high strength-to-weight ratio makes titanium (Ti) and its alloys an unavoidable material for long-term orthopaedic implant application. Though titanium was used as an implant material for many years, the sub-optimal osseointegration of titanium implants with the bone around them was minimal, leading to implant failure. For this study, combinational treatment of Commerically pure Titanium (Cp-Ti) by anodization using phosphate and fluoride electrolyte to form titania nanotubes (TNT) followed by dip coating with gadolinium nitrate solution. The corrosion behaviour of gadolinium coated TNT (Gd-TNT) show better corrosion resistance than TNT. The surface reactivity of the samples were analysed using scanning electrochemical microscope (SCEM). SECM is one of the powerful technique to determine the surface chemical recativity of metallic biomaterials in simulated body fluids. X-ray diffraction (XRD) analysis showed the anatase phase of titania nanotube formation. Attenuated Total Reflection Fourier Transform Infrared spectroscopy (ATR-FT-IR) was used to analyse the functional groups of the sample surface. The walls of the TNT were covered with gadolinium oxide which was confirmed by X-ray photoelectron spectroscopy (XPS) studies. Also, the mineralization of TNT-Gd was initiated after 24 h of immersion in simulated body fluid (SBF).
Purpose:
The purpose of this paper was to evaluate the response to intra-articular hip injections with and without concurrent gadolinium administration. Our secondary outcome was to compare post-operative outcomes between patients with an initial false-negative gadolinium-containing injection and a matched control group.
Methods:
Patients receiving a series of two hip diagnostic intra-articular injections (DIAI), the first with gadolinium for concurrent MRA and the second without gadolinium, were retrospectively identified. Pain response to DIAI, injectate volume, local anesthetic volume, inclusion of corticosteroids, and method of injection were compared between injections. False-negative injection was defined as < 50% pain relief with concurrent gadolinium, but ≥ 50% pain relief with subsequent anesthetic injection without gadolinium. False-negative injections in patients that ultimately underwent primary hip arthroscopy were identified from this cohort and matched in a 3:1 ratio to a control cohort to compare short-term post-operative single assessment numerical evaluation (SANE) outcomes.
Results:
Forty-three patients underwent a series of anesthetic injections with and without gadolinium and met inclusion and exclusion criteria. Pain response was significantly different in injections performed with and without gadolinium (18% vs. 81%; p < 0.001). There were significant differences in total injectate volume, local anesthetic volume, corticosteroid use, and method of injection between injections, but these variables were not correlated with pain response. Fifteen patients with false-negative responses to injection underwent primary hip arthroscopy and were matched in a 3:1 ratio to a control cohort. There was no difference in short-term post-operative SANE scores between the gadolinium-sensitive and control groups (81.6 vs. 80.0, n.s.).
Conclusion:
Concurrent administration of intra-articular gadolinium with DIAI may result in a false-negative response to anesthetic. Additionally, in patients with initial false-negative DIAI with gadolinium, short-term post-operative outcomes after hip arthroscopy are similar to a matched cohort.
Level of evidence:
Level III.
