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"Cooper, Nancy"
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Hepatocellular carcinoma detection: diagnostic performance of a simulated abbreviated MRI protocol combining diffusion-weighted and T1-weighted imaging at the delayed phase post gadoxetic acid
Purpose
The purpose of this study was to evaluate the diagnostic performance of a “simulated” abbreviated MRI (AMRI) protocol using diffusion-weighted imaging (DWI) and T1-weighted (T1w) imaging obtained at the hepatobiliary phase (HBP) post gadoxetic acid injection alone and in combination, compared to dynamic contrast-enhanced (CE)-T1w imaging for the detection of hepatocellular carcinoma (HCC).
Methods
This was an IRB approved HIPAA compliant retrospective single institution study including patients with liver disease who underwent gadoxetic acid-enhanced MRI for HCC diagnosis. Three independent observers assessed 2 sets of images (full CE-set and AMRI including DWI+T1w-HBP). Diagnostic performance of T1w-HBP and DWI alone and in combination was compared to that of CE-set. All imaging sets included unenhanced T1w and T2w sequences. A preliminary analysis was performed to assess cost savings of AMRI protocol compared to a full MRI study.
Results
174 patients including 62 with 80 HCCs were assessed. Equivalent per-patient sensitivity and negative predictive value (NPV) were observed for DWI (85.5% and 92.2%, pooled data) and T1w-HBP (89.8% and 94.2%) (
P
= 0.1–0.7), while these were significantly lower for the full AMRI protocol (DWI+T1w-HBP, 80.6% and 80%,
P
= 0.02) when compared to CE-set (90.3% and 94.9%). Higher specificity and positive predictive value were observed for CE-set vs. AMRI (
P
= 0.02). The estimated cost reduction of AMRI versus full MRI ranged between 30.7 and 49.0%.
Conclusion
AMRI using DWI and T1w-HBP has a clinically acceptable sensitivity and NPV for HCC detection. This could serve as the basis for a future study assessing AMRI for HCC screening and surveillance.
Journal Article
Retuning Javanese Identities: The Ironies of a Popular Genre
In this ethnographic analysis of the popular Javanese-Indonesian fusion genre campur sari, I focus on embedded cultural meanings while following the career trajectory of the late popularizer of the genre, Manthou's [sic]. A key site of contention lies in the choice of either indigenous or Western tuning systems by particular performing groups. Their choices reveal ambivalence toward modernization itself, resulting not only in renewed identities and musical fusions but also in alternative modernities. Ironically, gamelan musicians who play campur sari may also be preserving their treasured traditional music in an era in which social and economic support for classical genres is declining. Ini analisa etnografi tentang aliran musik Jawa-Indonesia campur sari. Saya akan menyetel lensa terhadap arti budaya dalam secara serempak ikut karir Manthou's, yang bikin populer musik hiburan tersebut. Tempat pertandingan penting adalah pilihan laras Jawa atau laras Barat oleh bermacam rombongan-rombongan campur sari. Pilihan mereka menyatakan dua perasaan yang bertentangan terhadap modernisasi yang mengakibatkan tidak hanya identias baru dan music perpaduan, tetapi kemoderan cadangan. Yang ironis bahwa niyaga gamelan yang main campur sari boleh juga cagar musik adi luhung di jaman ketika sokongan atas aliran klasik menurun.
Journal Article