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Published in: European Radiology 7/2006

01-07-2006 | Gastrointestinal

MR colonography: current status

Author: Thomas C. Lauenstein

Published in: European Radiology | Issue 7/2006

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Abstract

Magnetic resonance colonography (MRC) has gained access into clinical routine as a means for the assessment of the large bowel. There are widely accepted indications for MRC, especially in patients with incomplete conventional colonoscopy. Furthermore, virtual MRC is more and more propagated as a screening tool, with advantages especially inherent to the non-invasive character of this procedure and the lack of ionizing radiation exposition. Beyond a sufficiently high diagnostic accuracy, outstanding patient acceptance is a major advantage of MRC as a diagnostic modality. This review article describes indications, techniques and clinical outcome of current MRC approaches. Furthermore, the impact of fecal tagging concepts is discussed.
Literature
2.
go back to reference Muto T, Bussey HJ, Morson BC (1975) The evolution of cancer of the colon and rectum. Cancer 36:2251–2270PubMed Muto T, Bussey HJ, Morson BC (1975) The evolution of cancer of the colon and rectum. Cancer 36:2251–2270PubMed
3.
go back to reference Winawer SJ, O’Brien MJ, Waye JD et al (1990) Risk and surveillance of individuals with colorectal polyps. WHO Collaborating Center for the Prevention of Colorectal Cancer. World Health Organization bulletin. New York, 68:789–795 Winawer SJ, O’Brien MJ, Waye JD et al (1990) Risk and surveillance of individuals with colorectal polyps. WHO Collaborating Center for the Prevention of Colorectal Cancer. World Health Organization bulletin. New York, 68:789–795
4.
go back to reference Murakami R, Tsukuma H, Kanamori S et al (1990) Natural history of colorectal polyps and the effect of polypectomy on occurrence of cancer. Int J Cancer 46:159–164PubMedCrossRef Murakami R, Tsukuma H, Kanamori S et al (1990) Natural history of colorectal polyps and the effect of polypectomy on occurrence of cancer. Int J Cancer 46:159–164PubMedCrossRef
5.
go back to reference Winawer S, Fletcher R, Rex D et al (2003) Colorectal cancer screening and surveillance: clinical guidelines and rationale—update based on new evidence. Gastroenterology 124:544–560CrossRefPubMed Winawer S, Fletcher R, Rex D et al (2003) Colorectal cancer screening and surveillance: clinical guidelines and rationale—update based on new evidence. Gastroenterology 124:544–560CrossRefPubMed
6.
go back to reference Harewood GC, Wierseman MJ, Melton LJ 3rd (2002) A prospective, controlled assessment of factors influencing acceptance of screening colonoscopy. Am J Gastroenterol 97:3186–3194CrossRefPubMed Harewood GC, Wierseman MJ, Melton LJ 3rd (2002) A prospective, controlled assessment of factors influencing acceptance of screening colonoscopy. Am J Gastroenterol 97:3186–3194CrossRefPubMed
7.
go back to reference Dominitz JA, EIsen GM, Baron TH et al (2003) Complications of colonoscopy. Gastrointest Endosc 57:441–445CrossRefPubMed Dominitz JA, EIsen GM, Baron TH et al (2003) Complications of colonoscopy. Gastrointest Endosc 57:441–445CrossRefPubMed
8.
go back to reference Lieberman D (1994) Colon cancer screening: beyond efficacy. Gastroenterology 106:803–807PubMed Lieberman D (1994) Colon cancer screening: beyond efficacy. Gastroenterology 106:803–807PubMed
9.
go back to reference Frommer DJ (1998) What’s new in colorectal cancer screening? J Gastroenterol Hepatol 13:528–533PubMed Frommer DJ (1998) What’s new in colorectal cancer screening? J Gastroenterol Hepatol 13:528–533PubMed
10.
go back to reference Akekar GA, Yer J, Hung R et al (2001) Patient experience and preferences toward colon cancer screening: a comparison of virtual colonoscopy and conventional colonoscopy. Gastrointes Endosc 54:310–315CrossRef Akekar GA, Yer J, Hung R et al (2001) Patient experience and preferences toward colon cancer screening: a comparison of virtual colonoscopy and conventional colonoscopy. Gastrointes Endosc 54:310–315CrossRef
11.
go back to reference Thomeer M, Bielen D, Vanbeckevoort D et al (2002) Patient acceptance for CT colonography: what is the real issue? Eur Radiol 12:1410–1415CrossRefPubMed Thomeer M, Bielen D, Vanbeckevoort D et al (2002) Patient acceptance for CT colonography: what is the real issue? Eur Radiol 12:1410–1415CrossRefPubMed
12.
go back to reference McFarland EG, Brink JA, Pilgram TK, Heiken JP, Balfe DM, Hirselj DA, Weinstock L, Littenberg B (2001) Spiral CT colonography: reader agreement and diagnostic performance with two- and three-dimensional image-display techniques. Radiology 218:375–383PubMed McFarland EG, Brink JA, Pilgram TK, Heiken JP, Balfe DM, Hirselj DA, Weinstock L, Littenberg B (2001) Spiral CT colonography: reader agreement and diagnostic performance with two- and three-dimensional image-display techniques. Radiology 218:375–383PubMed
13.
go back to reference Dafnis G, Granath F, Pahlman L, Ekbom A, Blomqvist P (2005) Patient factors influencing the completion rate in colonoscopy. Dig Liver Dis 37:113–118CrossRefPubMed Dafnis G, Granath F, Pahlman L, Ekbom A, Blomqvist P (2005) Patient factors influencing the completion rate in colonoscopy. Dig Liver Dis 37:113–118CrossRefPubMed
14.
go back to reference Cirocco WC, Rusin LC (1995) Factors that predict incomplete colonoscopy. Dis Colon Rectum 389:964–968CrossRef Cirocco WC, Rusin LC (1995) Factors that predict incomplete colonoscopy. Dis Colon Rectum 389:964–968CrossRef
15.
go back to reference Pickhardt PJ, Choi JR, Hwang I, Butler JA, Puckett ML, Hildebrandt HA, Wong RK, Nugent PA, Mysliwiec PA, Schindler WR (2003) Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 349:2191–2200CrossRefPubMed Pickhardt PJ, Choi JR, Hwang I, Butler JA, Puckett ML, Hildebrandt HA, Wong RK, Nugent PA, Mysliwiec PA, Schindler WR (2003) Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 349:2191–2200CrossRefPubMed
16.
go back to reference Sosna J, Morrin MM, Kruskal JB, Lavin PT, Rosen MP, Raptopoulos V (2003) CT colonography of colorectal polyps: a metaanalysis. Am J Roentgenol 18:1593–1598PubMed Sosna J, Morrin MM, Kruskal JB, Lavin PT, Rosen MP, Raptopoulos V (2003) CT colonography of colorectal polyps: a metaanalysis. Am J Roentgenol 18:1593–1598PubMed
17.
go back to reference Johnson CD, Harmsen WS, Wilson LA, Maccarty RL, Welch TJ, Ilstrup DM, Ahlquist DA (2003) Prospective blinded evaluation of computed tomographic colonography for screen detection of colorectal polyps. Gastroenterology 125:311–319CrossRefPubMed Johnson CD, Harmsen WS, Wilson LA, Maccarty RL, Welch TJ, Ilstrup DM, Ahlquist DA (2003) Prospective blinded evaluation of computed tomographic colonography for screen detection of colorectal polyps. Gastroenterology 125:311–319CrossRefPubMed
18.
go back to reference Macari M, Bini EJ, Jacobs SL, Naik S, Lui YW, Milano A, Rajapaksa R, Megibow AJ, Babb J (2004) Colorectal polyps and cancers in asymptomatic average-risk patients: evaluation with CT colonography. Radiology 230:629–636PubMedCrossRef Macari M, Bini EJ, Jacobs SL, Naik S, Lui YW, Milano A, Rajapaksa R, Megibow AJ, Babb J (2004) Colorectal polyps and cancers in asymptomatic average-risk patients: evaluation with CT colonography. Radiology 230:629–636PubMedCrossRef
19.
go back to reference Luboldt W, Bauerfeind P, Wildermuth S, Marincek B, Fried M, Debatin JF (2000) Colonic masses: detection with MR colonography. Radiology 216:383–388PubMed Luboldt W, Bauerfeind P, Wildermuth S, Marincek B, Fried M, Debatin JF (2000) Colonic masses: detection with MR colonography. Radiology 216:383–388PubMed
20.
go back to reference Pappalardo G, Polettini E, Frattaroli FM, Casciani E, D’Orta C, D’Amato M, Gualdi GF (2000) Magnetic resonance colonography versus conventional colonoscopy for the detection of colonic endoluminal lesions. Gastroenterology 119:300–304CrossRefPubMed Pappalardo G, Polettini E, Frattaroli FM, Casciani E, D’Orta C, D’Amato M, Gualdi GF (2000) Magnetic resonance colonography versus conventional colonoscopy for the detection of colonic endoluminal lesions. Gastroenterology 119:300–304CrossRefPubMed
21.
go back to reference Lauenstein TC, Herborn CU, Vogt FM, Gohde SC, Debatin JF, Ruehm SG (2001) Dark lumen MR-colonography: initial experience. Rofo 173:785–789PubMed Lauenstein TC, Herborn CU, Vogt FM, Gohde SC, Debatin JF, Ruehm SG (2001) Dark lumen MR-colonography: initial experience. Rofo 173:785–789PubMed
22.
go back to reference Hartmann D, Bassler B, Schilling D et al (2006) Colorectal polyps: detection with dark-lumen MR colonography versus conventional colonoscopy. Radiology 238:143–149PubMedCrossRef Hartmann D, Bassler B, Schilling D et al (2006) Colorectal polyps: detection with dark-lumen MR colonography versus conventional colonoscopy. Radiology 238:143–149PubMedCrossRef
23.
go back to reference Debatin JF, Luboldt W, Bauerfeind P (1999) Virtual colonoscopy in 1999: computed tomography or magnetic resonance imaging? Endoscopy 31:174–179CrossRefPubMed Debatin JF, Luboldt W, Bauerfeind P (1999) Virtual colonoscopy in 1999: computed tomography or magnetic resonance imaging? Endoscopy 31:174–179CrossRefPubMed
25.
go back to reference Brenner DJ, Elliston CD (2004) Estimated radiation risks potentially associated with full-body CT screening. Radiology 232:735–738PubMedCrossRef Brenner DJ, Elliston CD (2004) Estimated radiation risks potentially associated with full-body CT screening. Radiology 232:735–738PubMedCrossRef
26.
go back to reference Murphy KJ, Brunberg JA, Cohan RH (1996) Adverse reactions to gadolinium contrast media: a review of 36 cases. Am J Reontgenol 167:847–849PubMed Murphy KJ, Brunberg JA, Cohan RH (1996) Adverse reactions to gadolinium contrast media: a review of 36 cases. Am J Reontgenol 167:847–849PubMed
27.
go back to reference Prince MR, Arnoldus C, Frisoli JK (1996) Nephrotoxicity of high-dose gadolinium compared with iodinated contrast. J Magn Reson Imaging 6:162–166PubMedCrossRef Prince MR, Arnoldus C, Frisoli JK (1996) Nephrotoxicity of high-dose gadolinium compared with iodinated contrast. J Magn Reson Imaging 6:162–166PubMedCrossRef
28.
go back to reference Winawer SJ, Zauber AG, O’Brien MJ, Gottlieb LS, Sternberg SS, Stewart ET, et al (1992) The National Polyp Study. Design, methods, and characteristics of patients with newly diagnosed polyps. The National Polyp Study Workgroup. Cancer 70:1236–1245PubMedCrossRef Winawer SJ, Zauber AG, O’Brien MJ, Gottlieb LS, Sternberg SS, Stewart ET, et al (1992) The National Polyp Study. Design, methods, and characteristics of patients with newly diagnosed polyps. The National Polyp Study Workgroup. Cancer 70:1236–1245PubMedCrossRef
29.
go back to reference Winkleman BJ, Matthews DE, Wiebke EA (2003) Colorectal cancer screening at a Veterans Affairs hospital. Am J Surg 186:468–471CrossRefPubMed Winkleman BJ, Matthews DE, Wiebke EA (2003) Colorectal cancer screening at a Veterans Affairs hospital. Am J Surg 186:468–471CrossRefPubMed
30.
go back to reference Saar B, Rosch T, Rummeny EJ (2002) Colorectal cancer screening: a challenge for magnetic resonance colonography. Top Magn Reson Imaging 13:427–434CrossRefPubMed Saar B, Rosch T, Rummeny EJ (2002) Colorectal cancer screening: a challenge for magnetic resonance colonography. Top Magn Reson Imaging 13:427–434CrossRefPubMed
31.
go back to reference Kuehle C, Ajaj W, Goehde SC, Nuefer M, Barkhausen J, Lauenstein TC (2005) MR colonography without bowel cleansing: diagnostic accuracy and patient acceptance. RSNA 2005 Kuehle C, Ajaj W, Goehde SC, Nuefer M, Barkhausen J, Lauenstein TC (2005) MR colonography without bowel cleansing: diagnostic accuracy and patient acceptance. RSNA 2005
32.
go back to reference Villavicencio RT, Rex DK (2000) Colonic adenomas: prevalence and incidence rates, growth rates, and miss rates at colonoscopy. Semin Gastrointest Dis 11:185–193PubMed Villavicencio RT, Rex DK (2000) Colonic adenomas: prevalence and incidence rates, growth rates, and miss rates at colonoscopy. Semin Gastrointest Dis 11:185–193PubMed
33.
go back to reference Hartmann D, Bassler B, Schilling D et al (2005) Incomplete conventional colonoscopy: magnetic resonance colonography in the evaluation of the proximal colon. Endoscopy 37:816–820CrossRefPubMed Hartmann D, Bassler B, Schilling D et al (2005) Incomplete conventional colonoscopy: magnetic resonance colonography in the evaluation of the proximal colon. Endoscopy 37:816–820CrossRefPubMed
34.
go back to reference Gryspeerdt S, Lefere P, Herman M et al (2005) CT colonography with fecal tagging after incomplete colonoscopy. Eur Radiol 15:1192–1202CrossRefPubMed Gryspeerdt S, Lefere P, Herman M et al (2005) CT colonography with fecal tagging after incomplete colonoscopy. Eur Radiol 15:1192–1202CrossRefPubMed
35.
go back to reference Ajaj W, Lauenstein TC, Pelster G, Holtmann G, Ruehm SG, Debatin JF, Goehde SC (2005) MR colonography in patients with incomplete conventional colonoscopy. Radiology 234:452–459PubMedCrossRef Ajaj W, Lauenstein TC, Pelster G, Holtmann G, Ruehm SG, Debatin JF, Goehde SC (2005) MR colonography in patients with incomplete conventional colonoscopy. Radiology 234:452–459PubMedCrossRef
36.
go back to reference Schreyer AG, Scheibl K, Heiss P, Feuerbach S, Seitz J, Herfarth H (2006) MR colonography in inflammatory bowel disease. Abdom Imaging, Jan 30 [Epub ahead of publication]; 10.1007/s00261-005-03776 Schreyer AG, Scheibl K, Heiss P, Feuerbach S, Seitz J, Herfarth H (2006) MR colonography in inflammatory bowel disease. Abdom Imaging, Jan 30 [Epub ahead of publication]; 10.1007/s00261-005-03776
37.
go back to reference Schreyer AG, Golder S, Scheibl K et al (2005) Dark lumen magnetic resonance enteroclysis in combination with MRI colonography for whole bowel assessment in patients with Crohn’s disease: first clinical experience. Inflamm Bowel Dis 11:388–394CrossRefPubMed Schreyer AG, Golder S, Scheibl K et al (2005) Dark lumen magnetic resonance enteroclysis in combination with MRI colonography for whole bowel assessment in patients with Crohn’s disease: first clinical experience. Inflamm Bowel Dis 11:388–394CrossRefPubMed
38.
go back to reference Narin B, Ajaj W, Gohde S et al (2004) Combined small and large bowel MR imaging in patients with Crohn’s disease: a feasibility study. Eur Radiol 14:1535–1542CrossRefPubMed Narin B, Ajaj W, Gohde S et al (2004) Combined small and large bowel MR imaging in patients with Crohn’s disease: a feasibility study. Eur Radiol 14:1535–1542CrossRefPubMed
39.
go back to reference Nahon S, Bouhnik Y, Lavergne-Slove A, Bitoun A, Panis Y, Valleur P et al (2002) Colonoscopy accurately predicts the anatomical severity of colonic Crohn’s disease attacks: correlation with findings from colectomy specimens. Am J Gastroenterol 12:3102–3107CrossRef Nahon S, Bouhnik Y, Lavergne-Slove A, Bitoun A, Panis Y, Valleur P et al (2002) Colonoscopy accurately predicts the anatomical severity of colonic Crohn’s disease attacks: correlation with findings from colectomy specimens. Am J Gastroenterol 12:3102–3107CrossRef
40.
go back to reference Fiocca R, Ceppa P (2003) The diagnostic reliability of endoscopic biopsies in diagnosis colitis. J Clin Pathol 56:321–322CrossRefPubMed Fiocca R, Ceppa P (2003) The diagnostic reliability of endoscopic biopsies in diagnosis colitis. J Clin Pathol 56:321–322CrossRefPubMed
41.
go back to reference Schreyer AG, Rath HC, Kikinis R, Volk M, Scholmerich J, Feuerbach S, Rogler G, Seitz J, Herfarth H (2005) Comparison of magnetic resonance imaging colonography with conventional colonoscopy for the assessment of intestinal inflammation in patients with inflammatory bowel disease: a feasibility study. Gut 54:250–256CrossRefPubMed Schreyer AG, Rath HC, Kikinis R, Volk M, Scholmerich J, Feuerbach S, Rogler G, Seitz J, Herfarth H (2005) Comparison of magnetic resonance imaging colonography with conventional colonoscopy for the assessment of intestinal inflammation in patients with inflammatory bowel disease: a feasibility study. Gut 54:250–256CrossRefPubMed
42.
go back to reference Koh DM, Miao Y, Chinn RJ, Amin Z, Zeegen R, Westaby D et al (2001) MR imaging evaluation of the activity of Crohn’s disease. Am J Roentgenol 6:1325–1332 Koh DM, Miao Y, Chinn RJ, Amin Z, Zeegen R, Westaby D et al (2001) MR imaging evaluation of the activity of Crohn’s disease. Am J Roentgenol 6:1325–1332
43.
go back to reference Ajaj W, Lauenstein TC, Pelster G, Gerken G, Ruehm SG, Debatin JF et al (2005) MR colonography for the detection of inflammatory diseases of the large bowel: quantifying the inflammatory activity. Gut 54:257–263CrossRefPubMed Ajaj W, Lauenstein TC, Pelster G, Gerken G, Ruehm SG, Debatin JF et al (2005) MR colonography for the detection of inflammatory diseases of the large bowel: quantifying the inflammatory activity. Gut 54:257–263CrossRefPubMed
44.
go back to reference Schreyer AG, Furst A, Agha A et al (2004) Magnetic resonance imaging based colonography for diagnosis and assessment of diverticulosis and diverticulitis. Int J Colorectal Dis 19:474–480CrossRefPubMed Schreyer AG, Furst A, Agha A et al (2004) Magnetic resonance imaging based colonography for diagnosis and assessment of diverticulosis and diverticulitis. Int J Colorectal Dis 19:474–480CrossRefPubMed
45.
go back to reference Ajaj W, Ruehm SG, Lauenstein T et al (2005) Dark-lumen magnetic resonance colonography in patients with suspected sigmoid diverticulitis: a feasibility study. Eur Radiol 15:2316–2322CrossRefPubMed Ajaj W, Ruehm SG, Lauenstein T et al (2005) Dark-lumen magnetic resonance colonography in patients with suspected sigmoid diverticulitis: a feasibility study. Eur Radiol 15:2316–2322CrossRefPubMed
46.
go back to reference Saar B, Hoppe H, Gschossmann JM, Stoupis C, Vock P, Netzer P (2005) 3 Tesla magnetic resonance imaging: a prospective pilot study of dark lumen MR-colonography for detection and characterization of colorectal lesions. RSNA 2005 Saar B, Hoppe H, Gschossmann JM, Stoupis C, Vock P, Netzer P (2005) 3 Tesla magnetic resonance imaging: a prospective pilot study of dark lumen MR-colonography for detection and characterization of colorectal lesions. RSNA 2005
47.
go back to reference Hawighorst H, Schoenberg SO, Knopp MV, Essig M, Miltner P, van Kaick G (1999) Hepatic lesions: morphologic and functional characterization with multiphase breath-hold 3D gadolinium-enhanced MR angiography—initial results. Radiology 210:89–96PubMed Hawighorst H, Schoenberg SO, Knopp MV, Essig M, Miltner P, van Kaick G (1999) Hepatic lesions: morphologic and functional characterization with multiphase breath-hold 3D gadolinium-enhanced MR angiography—initial results. Radiology 210:89–96PubMed
48.
go back to reference Ajaj W, Pelster G, Treichel U et al (2003) Dark lumen magnetic resonance colonography: comparison with conventional colonoscopy for the detection of colorectal pathology. Gut 52:1738–1743CrossRefPubMed Ajaj W, Pelster G, Treichel U et al (2003) Dark lumen magnetic resonance colonography: comparison with conventional colonoscopy for the detection of colorectal pathology. Gut 52:1738–1743CrossRefPubMed
49.
go back to reference Elwood MJ, Ali G, Schlup MT et al (1995) Flexible sigmoidoscopy or colonoscopy for colorectal screening: a randomized trial of performance and acceptability. Cancer Detec Prev 19:337–347PubMed Elwood MJ, Ali G, Schlup MT et al (1995) Flexible sigmoidoscopy or colonoscopy for colorectal screening: a randomized trial of performance and acceptability. Cancer Detec Prev 19:337–347PubMed
50.
go back to reference Lauenstein T, Holtmann G, Schoenfelder D et al (2001) MR colonography without colonic cleansing: a new strategy to improve patient acceptance. Am J Roentgenol 177:823–827PubMed Lauenstein T, Holtmann G, Schoenfelder D et al (2001) MR colonography without colonic cleansing: a new strategy to improve patient acceptance. Am J Roentgenol 177:823–827PubMed
51.
go back to reference Lauenstein TC, Goehde SC, Ruehm SG et al (2002) MR colonography with barium-based fecal tagging: initial clinical experience. Radiology 223:248–254PubMedCrossRef Lauenstein TC, Goehde SC, Ruehm SG et al (2002) MR colonography with barium-based fecal tagging: initial clinical experience. Radiology 223:248–254PubMedCrossRef
52.
go back to reference Papanikolaou N, Grammatikakis J, Maris T, Lauenstein T, Prassopoulos P, Gourtsoyiannis N (2003) MR colonography with fecal tagging: comparison between 2D turbo FLASH and 3D FLASH sequences. Eur Radiol 13:448–452PubMed Papanikolaou N, Grammatikakis J, Maris T, Lauenstein T, Prassopoulos P, Gourtsoyiannis N (2003) MR colonography with fecal tagging: comparison between 2D turbo FLASH and 3D FLASH sequences. Eur Radiol 13:448–452PubMed
53.
go back to reference Goehde SC, Descher E, Boekstegers A et al (2005) Dark lumen MR colonography based on fecal tagging for detection of colorectal masses: accuracy and patient acceptance. Abdom Imaging 30:576–583CrossRefPubMed Goehde SC, Descher E, Boekstegers A et al (2005) Dark lumen MR colonography based on fecal tagging for detection of colorectal masses: accuracy and patient acceptance. Abdom Imaging 30:576–583CrossRefPubMed
54.
go back to reference Ajaj W, Lauenstein TC, Schneemann H et al (2005) Magnetic resonance colonography without bowel cleansing using oral and rectal stool softeners (fecal cracking)—a feasibility study. Eur Radiol 15:2079–2087CrossRefPubMed Ajaj W, Lauenstein TC, Schneemann H et al (2005) Magnetic resonance colonography without bowel cleansing using oral and rectal stool softeners (fecal cracking)—a feasibility study. Eur Radiol 15:2079–2087CrossRefPubMed
Metadata
Title
MR colonography: current status
Author
Thomas C. Lauenstein
Publication date
01-07-2006
Publisher
Springer-Verlag
Published in
European Radiology / Issue 7/2006
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-006-0260-z

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