Diffusion-weighted MR imaging in musculoskeletal diseases: Current concepts.

MR imaging is currently regarded as a pivotal technique for the assessment of a variety of musculoskeletal conditions. Diffusion-weighted MR imaging (DWI) is a relatively recent sequence that provides information on the degree of cellularity of lesions. Apparent diffusion coefficient (ADC) value provides information on the movement of water molecules outside the cells. The literature contains many studies that have evaluated the role of DWI in musculoskeletal diseases. However, to date they yielded conflicting results on the use and the diagnostic capabilities of DWI in the area of musculoskeletal diseases. However, many of them have showed that DWI is a useful technique for the evaluation of the extent of the disease in a subset of musculoskeletal cancers. In terms of tissue characterization, DWI may be an adjunct to the more conventional MR imaging techniques but should be interpreted along with the signal of the lesion as observed on conventional sequences, especially in musculoskeletal cancers. Regarding the monitoring of response to therapy in cancer or inflammatory disease, the use of ADC value may represent a more reliable additional tool but must be compared to the initial ADC value of the lesions along with the knowledge of the actual therapy.

Addition of MR imaging features and genetic biomarkers strengthens glioblastoma survival prediction in TCGA patients.

PURPOSE: The purpose of our study was to assess whether a model combining clinical factors, MR imaging features, and genomics would better predict overall survival of patients with glioblastoma (GBM) than either individual data type. METHODS: The study was conducted leveraging The Cancer Genome Atlas (TCGA) effort supported by the National Institutes of Health. Six neuroradiologists reviewed MRI images from The Cancer Imaging Archive (http://cancerimagingarchive.net) of 102 GBM patients using the VASARI scoring system. The patients' clinical and genetic data were obtained from the TCGA website (http://www.cancergenome.nih.gov/). Patient outcome was measured in terms of overall survival time. The association between different categories of biomarkers and survival was evaluated using Cox analysis. RESULTS: The features that were significantly associated with survival were: (1) clinical factors: chemotherapy; (2) imaging: proportion of tumor contrast enhancement on MRI; and (3) genomics: HRAS copy number variation. The combination of these three biomarkers resulted in an incremental increase in the strength of prediction of survival, with the model that included clinical, imaging, and genetic variables having the highest predictive accuracy (area under the curve 0.679±0.068, Akaike's information criterion 566.7, P<0.001). CONCLUSION: A combination of clinical factors, imaging features, and HRAS copy number variation best predicts survival of patients with GBM.

2015 Update on Acute Adverse Reactions to Gadolinium based Contrast Agents in Cardiovascular MR. Large Multi-National and Multi-Ethnical Population Experience With 37788 Patients From the EuroCMR Registry.

OBJECTIVES: Specifically we aim to demonstrate that the results of our earlier safety data hold true in this much larger multi-national and multi-ethnical population. BACKGROUND: We sought to re-evaluate the frequency, manifestations, and severity of acute adverse reactions associated with administration of several gadolinium- based contrast agents during routine CMR on a European level. METHODS: Multi-centre, multi-national, and multi-ethnical registry with consecutive enrolment of patients in 57 European centres. RESULTS: During the current observation 37,788 doses of Gadolinium based contrast agent were administered to 37,788 patients. The mean dose was 24.7 ml (range 5-80 ml), which is equivalent to 0.123 mmol/kg (range 0.01 - 0.3 mmol/kg). Forty-five acute adverse reactions due to contrast administration occurred (0.12%). Most reactions were classified as mild (43 of 45) according to the American College of Radiology definition. The most frequent complaints following contrast administration were rashes and hives (15 of 45), followed by nausea (10 of 45) and flushes (10 of 45). The event rate ranged from 0.05% (linear non-ionic agent gadodiamide) to 0.42% (linear ionic agent gadobenate dimeglumine). Interestingly, we also found different event rates between the three main indications for CMR ranging from 0.05% (risk stratification in suspected CAD) to 0.22% (viability in known CAD). CONCLUSIONS: The current data indicate that the results of the earlier safety data hold true in this much larger multi-national and multi-ethnical population. Thus, the "off-label" use of Gadolinium based contrast in cardiovascular MR should be regarded as safe concerning the frequency, manifestation and severity of acute events.

Overture de l'opera Le Roi Theodore par mr Paesiello

Simananniemen käsikirjoituskokoelma.

Yritysmuodon vaikutus verotuksen edullisuuteen, case Lahden Betonilattiat Oy / Tmi MR-Rakennus & Remontti

Suomessa verotuksen tarkoituksena ei ole vaikuttaa yritysmuodon valintaan. Yritystä perustettaessa kiinnitetään kuitenkin usein erityistä huomiota verotukseen. Yrityksen ja omistajayrittäjän verotukseen vaikuttavat monet eri tekijät. Yleispäteviä saantoja yritysmuodon vaikutuksesta verotuksen edullisuuteen on mahdoton antaa ja siksi harkinta täytyy tehdä aina tilannekohtaisesti. Tärkeintä verotuksen edullisuuslaskelmissa on kokonaisrasituksen mittaaminen. Tutkimuksessa on vertailtu kahden samalla toimialalla toimivan pienyrityksen yritysmuodon vaikutusta verotuksen edullisuuteen. Tutkimuksen tavoitteena on ollut selvittää omistajayrittäjille jäävän nettotulon määrä. Tutkimuksen kohteena olevat yritykset ovat Lahden Betonilattiat Oy ja Tmi MR-Rakennus & Remontti, joista ensimmäinen on yritysmuodoltaan osakeyhtiö ja toinen yksityisliike. Tutkimusongelman ratkaisemiseksi tutkimuksessa on perehdytty yritysten kirjanpitoon ja tilinpaatostietoihin. Niiden avulla on laskettu yritysten nettovarallisuus, tulonmuodostus ja verot. Siten on saatu konkreettinen tulos siitä, kuinka paljon on ollut omistajayrittäjien kokonaisverorasitus ja käteen jäävän nettotulon määrä. Tutkimuksessa on oletettu tilikauden voiton otetun kokonaisuudessaan osakkaan käyttöön. Lisäksi on tutkittu miten tilanne muuttuu voiton ja nettovarallisuuden kasvaessa. Tutkimuksen tulosten perusteella todetaan yksityisliikkeen olevan verotuksen kannalta osakeyhtiötä edullisempi vaihtoehto. Yritysten voiton ja nettovarallisuuden kasvaessa havaitaan yksityisliikkeen lähes aina olevan osakeyhtiötä edullisempi yritysmuoto. Osakeyhtiö on yksityisliikettä edullisempi vaihtoehto ainoastaan silloin, kun sen nettovarallisuus on huomattavan suuri ja paljon yksityisliikkeen nettovarallisuutta suurempi.