Clinical radiology最新文献

英文中文

Re: Utility of zero echo time (ZTE) sequence for assessing bony lesions of skull base and calvarium: Challenges and expanding the applications of ZTE MRI in paediatric radiology

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-02-15 DOI: 10.1016/j.crad.2025.106855

T.S.E. Tan

引用次数: 0

Deploying AI in radiology.

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-02-15 DOI: 10.1016/j.crad.2025.106856

F J Gilbert

引用次数: 0

Pulmonary disease in paediatric patients with trisomy 21: a review of imaging findings

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-02-14 DOI: 10.1016/j.crad.2025.106857

C. McDonnell , H. Elbaaly , R. O'Reilly , M. Courtney , A.T. Byrne

AIM

Trisomy 21, also known as Down syndrome, is the most common chromosomal abnormality seen in live births and is associated with congenital abnormalities involving multiple organ systems. While the congenital cardiac and gastrointestinal associations of trisomy 21 are well known, the associated pulmonary radiological findings are less widely described. Our objective is to assess the presence, categories, and prevalence of pulmonary radiological findings in patients with trisomy 21, and to describe and provide reference images of these findings.

MATERIALS AND METHODS

A database of patients with a confirmed diagnosis of trisomy 21 was provided by the congenital cardiac disease clinic. One hundred thirty-four patients who had undergone computed tomography (CT) imaging of the chest were then identified from this database, all of whom had a diagnosis of congenital cardiac disease. A retrospective review of imaging findings of these 134 patients was then conducted by two specialist consultant paediatric radiologists and a paediatric radiology fellow.

RESULTS

The CTs of 62 patients demonstrated no abnormality. The CTs of the remaining 72 patients were abnormal. Air trapping (present in 35% of patients), subpleural cysts (17%), bronchiectasis (4%), findings suggestive of bronchopulmonary dysplasia (3%), and abnormalities of the tracheobronchial tree (4%) were among the abnormalities demonstrated.

CONCLUSION

This retrospective review describes the spectrum of thoracic radiological findings seen in patients with trisomy 21. This is of increasing value to practicing radiologists due to the rising life expectancy in this population.

{"title":"Pulmonary disease in paediatric patients with trisomy 21: a review of imaging findings","authors":"C. McDonnell , H. Elbaaly , R. O'Reilly , M. Courtney , A.T. Byrne","doi":"10.1016/j.crad.2025.106857","DOIUrl":"10.1016/j.crad.2025.106857","url":null,"abstract":"<div><h3>AIM</h3><div>Trisomy 21, also known as Down syndrome, is the most common chromosomal abnormality seen in live births and is associated with congenital abnormalities involving multiple organ systems. While the congenital cardiac and gastrointestinal associations of trisomy 21 are well known, the associated pulmonary radiological findings are less widely described. Our objective is to assess the presence, categories, and prevalence of pulmonary radiological findings in patients with trisomy 21, and to describe and provide reference images of these findings.</div></div><div><h3>MATERIALS AND METHODS</h3><div>A database of patients with a confirmed diagnosis of trisomy 21 was provided by the congenital cardiac disease clinic. One hundred thirty-four patients who had undergone computed tomography (CT) imaging of the chest were then identified from this database, all of whom had a diagnosis of congenital cardiac disease. A retrospective review of imaging findings of these 134 patients was then conducted by two specialist consultant paediatric radiologists and a paediatric radiology fellow.</div></div><div><h3>RESULTS</h3><div>The CTs of 62 patients demonstrated no abnormality. The CTs of the remaining 72 patients were abnormal. Air trapping (present in 35% of patients), subpleural cysts (17%), bronchiectasis (4%), findings suggestive of bronchopulmonary dysplasia (3%), and abnormalities of the tracheobronchial tree (4%) were among the abnormalities demonstrated.</div></div><div><h3>CONCLUSION</h3><div>This retrospective review describes the spectrum of thoracic radiological findings seen in patients with trisomy 21. This is of increasing value to practicing radiologists due to the rising life expectancy in this population.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"84 ","pages":"Article 106857"},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Safety and efficacy of stent-assisted coiling of unruptured distal anterior cerebral artery aneurysms with low-profile braided stents

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-02-14 DOI: 10.1016/j.crad.2025.106848

G. Zhang , Y. Shen , H. Ni, Z. Jia, X. Liu, B. Wang, G. Lu, H. Shi, L. Zhao, S. Liu

AIM

Distal anterior cerebral artery (ACA) aneurysms are a rare and difficult entity to manage. In this single-centre retrospective case series, we aimed to investigate the safety and efficacy of LEO Baby stent-assisted coiling (SAC) for the treatment of unruptured distal ACA aneurysms.

MATERIAL AND METHODS

This retrospective study aims to identify patients with unruptured distal ACA aneurysms treated with LEO Baby stent-assisted coiling in a single institution from October 2018 to October 2022. We assessed the immediate and follow-up aneurysm occlusion rates, procedure-related complications, and clinical outcomes.

RESULTS

A total of 20 patients with 21 aneurysms were identified. Technical success was achieved in all cases. The immediate angiography showed complete occlusion in 14 aneurysms (66.7%), neck remnants in 6 (28.6%), and residual sac in 1 (4.8%). Procedure-related ischaemic complications occurred in 2 cases (10%), with one patient leaving mild contralateral low extremity weakness. Six-month follow-up angiography was achieved in 15 (71.4%) aneurysms, which showed complete occlusion in all 15 aneurysms. Clinical follow-up was available in all patients with a median duration of 18.8 ± 10.19 months, and all patients had a favourable clinical outcome (modified Rankin Scale score: 0–2).

CONCLUSION

This study demonstrates that stent-assisted coiling of intracranial aneurysms located on distal ACA with LEO Baby stents is technically feasible, highly effective, and has midterm durability in aneurysmal occlusion.

{"title":"Safety and efficacy of stent-assisted coiling of unruptured distal anterior cerebral artery aneurysms with low-profile braided stents","authors":"G. Zhang , Y. Shen , H. Ni, Z. Jia, X. Liu, B. Wang, G. Lu, H. Shi, L. Zhao, S. Liu","doi":"10.1016/j.crad.2025.106848","DOIUrl":"10.1016/j.crad.2025.106848","url":null,"abstract":"<div><h3>AIM</h3><div>Distal anterior cerebral artery (ACA) aneurysms are a rare and difficult entity to manage. In this single-centre retrospective case series, we aimed to investigate the safety and efficacy of LEO Baby stent-assisted coiling (SAC) for the treatment of unruptured distal ACA aneurysms.</div></div><div><h3>MATERIAL AND METHODS</h3><div>This retrospective study aims to identify patients with unruptured distal ACA aneurysms treated with LEO Baby stent-assisted coiling in a single institution from October 2018 to October 2022. We assessed the immediate and follow-up aneurysm occlusion rates, procedure-related complications, and clinical outcomes.</div></div><div><h3>RESULTS</h3><div>A total of 20 patients with 21 aneurysms were identified. Technical success was achieved in all cases. The immediate angiography showed complete occlusion in 14 aneurysms (66.7%), neck remnants in 6 (28.6%), and residual sac in 1 (4.8%). Procedure-related ischaemic complications occurred in 2 cases (10%), with one patient leaving mild contralateral low extremity weakness. Six-month follow-up angiography was achieved in 15 (71.4%) aneurysms, which showed complete occlusion in all 15 aneurysms. Clinical follow-up was available in all patients with a median duration of 18.8 ± 10.19 months, and all patients had a favourable clinical outcome (modified Rankin Scale score: 0–2).</div></div><div><h3>CONCLUSION</h3><div>This study demonstrates that stent-assisted coiling of intracranial aneurysms located on distal ACA with LEO Baby stents is technically feasible, highly effective, and has midterm durability in aneurysmal occlusion.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"84 ","pages":"Article 106848"},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advanced MRI prediction model for anatomical site identification in uterine carcinoma: enhancing diagnostic accuracy

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-02-14 DOI: 10.1016/j.crad.2025.106852

M. Malek , M. Moayeri , S. Akhavan , S.S. Hasani , F. Nili , Z. Mahboubi- Fooladi

Aim

The uterine carcinoma is the most commonly diagnosed malignancy in the female pelvis. Accurate identification of tumour origin is crucial for determining appropriate treatment approaches. This study aims to develop a prediction model using multiple MRI parameters to accurately diagnose uterine cancer with an indistinctive origin and those involving both the endometrium and cervix prior to treatment.

Material and methods

This prospective cohort study included patients who were newly diagnosed with uterine carcinoma who underwent MRI and were considered for hysterectomy within 6 months after MRI.

Results

A total of 78 patients with uterine carcinoma were enrolled. Certain imaging features were found to be consistent with cervical carcinoma, included parametrial, vaginal, stromal invasion, and peripheral rim enhancement. Cervical cancer appeared hyperintense compared to the myometrium unlike endometrial cancer.

Discussion

The study found that certain morphologic features were reliable indicators for detecting cervical carcinoma.

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引用次数: 0

Ultrasonographic assessment of the uterocervical angle in the second trimester of pregnancy as a predictor of spontaneous preterm birth

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-02-14 DOI: 10.1016/j.crad.2025.106853

E.G. Nicolau , L.O. Reis

AIM

To evaluate the uterocervical angle in the second trimester in singleton pregnancies as a predictor of spontaneous preterm labour.

MATERIAL AND METHODS

An observational cohort study was carried out from March 2022 to May 2023, including consecutively selected patients with singleton pregnancies who underwent routine examinations between 18.0 and 23.6 weeks to analyse the risk of prematurity. The uterocervical angle (UCA) measurement was added to the transvaginal ultrasonographic analysis of the cervix. Birth-related outcomes were prospectively collected.

RESULTS

patients were evaluated. The occurrence of spontaneous preterm birth (sPTB) before 37 weeks was 12%, with 50 patients. An association was observed between a more obtuse uterocervical angle and the occurrence of birth before 37 weeks, with the area under the curve of 0.636 (p=0.003; 95% CI: 0.546–0.726). The cutoff point of 77.2 degrees demonstrated a sensitivity of 80% and specificity of 29.4% (p=0.003), a positive predictive value of 13.6%, and a negative predictive value of 91.3%, with a positive likelihood ratio of 1.13 and negative 0.88.

CONCLUSION

The measurement of UCA in the second trimester of pregnancy is associated with the occurrence of sPTB. The result corroborates recent literature conclusions that UCA is a relatively recent predictor of sPTB. New evidence in different populations may contribute to its possible incorporation into prematurity risk assessment.

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引用次数: 0

Characterisation of respiratory mechanics in adults with CF using dynamic chest radiography

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-02-13 DOI: 10.1016/j.crad.2025.106841

T.S. FitzMaurice , C. McCann , R. Bedi , D.S. Nazareth , M.J. Walshaw , P.S. McNamara

BACKGROUND

As the lifespan of people with CF (pwCF) improves, sensitive markers of lung health are needed. Dynamic chest radiography (DCR) is a low ionising radiation dose cineradiographic imaging system that provides real-time information on moving thoracic structures. We examined whether DCR provides quantitative motion analysis that correlates with pulmonary function, anthropometric and clinical variables in pwCF, to explore DCR as a marker of lung health.

METHODS

In this prospective, observational, single-centre, non-controlled study, participantsunderwent DCR and spirometry. We measured DCR parameters such as diaphragm motion and change in projected lung area (ΔPLA). The study is registered on the ________ registry (ID __________). Correlation was assessed using Spearman’s coefficient, and relationships between DCR and spirometric variables using linear regression modelling. Descriptive statistics are reported as mean ± standard deviation and median (interquartile range) as appropriate.

RESULTS

We assessed 129 adult pwCF (age 29[12] years, 48 female, ppFEV1 69±25). Average inspiratory lung area (PLAinsp) was 424±72cm2, and expiratory lung area (PLAexp) 325±68cm2. Left diaphragm motion range was 34±12mm, right 29±12mm. ΔPLA correlated with FEV1 (ρ=0.70,P<0.001). PLAinsp correlated with FVC (ρ=0.56,P<0.001). PLAexp correlated with FEV1/FVC ratio (ρ=-0.49,P<0.001). BMI correlated with ΔPLA (ρ=0.29,P=0.001) and deep breathing hemidiaphragm excursion (right, ρ=0.4,P<0.001; left 0.39,P<0.001).

CONCLUSIONS

This study is the first to describe diaphragm motion and projected lung areas using DCR in non-exacerbating adult pwCF, and complements work by our group demonstrating change in DCR parameters in pwCF undergoing pharmacological interventions. DCR shows potential as a tool to investigate lung health in pwCF.

{"title":"Characterisation of respiratory mechanics in adults with CF using dynamic chest radiography","authors":"T.S. FitzMaurice , C. McCann , R. Bedi , D.S. Nazareth , M.J. Walshaw , P.S. McNamara","doi":"10.1016/j.crad.2025.106841","DOIUrl":"10.1016/j.crad.2025.106841","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>As the lifespan of people with CF (pwCF) improves, sensitive markers of lung health are needed. Dynamic chest radiography (DCR) is a low ionising radiation dose cineradiographic imaging system that provides real-time information on moving thoracic structures. We examined whether DCR provides quantitative motion analysis that correlates with pulmonary function, anthropometric and clinical variables in pwCF, to explore DCR as a marker of lung health.</div></div><div><h3>METHODS</h3><div>In this prospective, observational, single-centre, non-controlled study, participantsunderwent DCR and spirometry. We measured DCR parameters such as diaphragm motion and change in projected lung area (ΔPLA). The study is registered on the ________ registry (ID __________). Correlation was assessed using Spearman’s coefficient, and relationships between DCR and spirometric variables using linear regression modelling. Descriptive statistics are reported as mean ± standard deviation and median (interquartile range) as appropriate.</div></div><div><h3>RESULTS</h3><div>We assessed 129 adult pwCF (age 29[12] years, 48 female, ppFEV1 69±25). Average inspiratory lung area (PLAinsp) was 424±72cm2, and expiratory lung area (PLAexp) 325±68cm2. Left diaphragm motion range was 34±12mm, right 29±12mm. ΔPLA correlated with FEV1 (ρ=0.70,P<0.001). PLAinsp correlated with FVC (ρ=0.56,P<0.001). PLAexp correlated with FEV1/FVC ratio (ρ=-0.49,P<0.001). BMI correlated with ΔPLA (ρ=0.29,P=0.001) and deep breathing hemidiaphragm excursion (right, ρ=0.4,P<0.001; left 0.39,P<0.001).</div></div><div><h3>CONCLUSIONS</h3><div>This study is the first to describe diaphragm motion and projected lung areas using DCR in non-exacerbating adult pwCF, and complements work by our group demonstrating change in DCR parameters in pwCF undergoing pharmacological interventions. DCR shows potential as a tool to investigate lung health in pwCF.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"83 ","pages":"Article 106841"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Awake biopsy in paediatric patients with suspected musculoskeletal malignancy is feasible, cost-effective and reduces time to obtaining tissue

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-02-13 DOI: 10.1016/j.crad.2025.106850

H.R.F. Walters , A. Kothari , M. Mifsud , A. Wainwright , K. Partington

Aim

This study aims to evaluate the utility, feasibility, time, and cost-effectiveness of awake ultrasound-guided percutaneous biopsies (AUPBs) in children with suspected musculoskeletal tumours, when compared with more conventional biopsies under general anaesthesia (BGAs).

Materials and Methods

A retrospective analysis of paediatric biopsies performed in a UK tertiary musculoskeletal centre between March 2016 and March 2023 was undertaken. Eighty-six paediatric patients were included in the study, 53 undergoing BGA and 33 undergoing AUPB.

Results

The mean age of patients undergoing AUPB was more than that of patients undergoing BGA at 13.2 years (range: 5-16 years) and 8.5 years (range: 3 months-15 years), respectively. AUPB significantly reduced the time to biopsy, with a mean of 4.7 days (median: 3 days, interquartile range [IQR]: 2-7 days), compared with 11.1 days (median: 5 days, IQR: 2-18 days) for BGAs (P = 0.037). AUPB conferred a one-third reduction in financial cost at £1177 vs £1824 for BGA. Fifty-eight percent patients undergoing AUPB had their biopsy on the same day as their initial assessment in clinic, whilst none of the BGA cases had their biopsy on the same day as their initial assessment in clinic. No complications or procedural abandonment were reported in the AUPB group.

Conclusion

Awake ultrasound-guided biopsy in paediatric musculoskeletal tumours is safe, well tolerated, and cost-effective. It reduces the time to obtain a histological diagnosis compared to BGA. Collaboration between clinicians, radiologists, and play specialists in identifying suitable patients for AUPB can facilitate efficient one-stop clinics and timely diagnosis and reduce costs incurred in paediatric oncological services.

Level of Evidence

Level IV—Diagnostic.

{"title":"Awake biopsy in paediatric patients with suspected musculoskeletal malignancy is feasible, cost-effective and reduces time to obtaining tissue","authors":"H.R.F. Walters , A. Kothari , M. Mifsud , A. Wainwright , K. Partington","doi":"10.1016/j.crad.2025.106850","DOIUrl":"10.1016/j.crad.2025.106850","url":null,"abstract":"<div><h3>Aim</h3><div>This study aims to evaluate the utility, feasibility, time, and cost-effectiveness of awake ultrasound-guided percutaneous biopsies (AUPBs) in children with suspected musculoskeletal tumours, when compared with more conventional biopsies under general anaesthesia (BGAs).</div></div><div><h3>Materials and Methods</h3><div>A retrospective analysis of paediatric biopsies performed in a UK tertiary musculoskeletal centre between March 2016 and March 2023 was undertaken. Eighty-six paediatric patients were included in the study, 53 undergoing BGA and 33 undergoing AUPB.</div></div><div><h3>Results</h3><div>The mean age of patients undergoing AUPB was more than that of patients undergoing BGA at 13.2 years (range: 5-16 years) and 8.5 years (range: 3 months-15 years), respectively. AUPB significantly reduced the time to biopsy, with a mean of 4.7 days (median: 3 days, interquartile range [IQR]: 2-7 days), compared with 11.1 days (median: 5 days, IQR: 2-18 days) for BGAs (<em>P</em> = 0.037). AUPB conferred a one-third reduction in financial cost at £1177 vs £1824 for BGA. Fifty-eight percent patients undergoing AUPB had their biopsy on the same day as their initial assessment in clinic, whilst none of the BGA cases had their biopsy on the same day as their initial assessment in clinic. No complications or procedural abandonment were reported in the AUPB group.</div></div><div><h3>Conclusion</h3><div>Awake ultrasound-guided biopsy in paediatric musculoskeletal tumours is safe, well tolerated, and cost-effective. It reduces the time to obtain a histological diagnosis compared to BGA. Collaboration between clinicians, radiologists, and play specialists in identifying suitable patients for AUPB can facilitate efficient one-stop clinics and timely diagnosis and reduce costs incurred in paediatric oncological services.</div></div><div><h3>Level of Evidence</h3><div>Level IV—Diagnostic.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"84 ","pages":"Article 106850"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cone beam CT pulmonary angiography in balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension during the program initiation period

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-02-13 DOI: 10.1016/j.crad.2025.106847

A. Páez-Carpio , F.X. Zarco , E. Serrano , I. Vollmer , J. Puig , J.A. Barberà , F.M. Gómez , I. Blanco

AIM

Cone beam CT pulmonary angiography (CBCT-PA) has proven to be a valuable technique during balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH) in established centres. This study aimed to demonstrate the safety and efficacy of CBCT-PA–guided BPA for CTEPH during the initial period of a BPA program. CBCT-PA improves procedural accuracy by visualising distal thromboembolic lesions and providing real-time guidance, which is critical during program initiation.

MATERIALS AND METHODS

This single-centre, single-arm study prospectively evaluated patients with CTEPH undergoing BPA from 2017 to 2022. Outcomes of interest included pre-BPA and post-BPA 6-minute walking distance, New York Heart Association Functional Classification (NYHA-FC), mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), N-terminal pro B-type natriuretic peptide (NT-proBNP), and BPA-related adverse events (AEs). Statistical analysis compared pre-BPA and post-BPA results. CBCT-PA was used for three-dimensional (3D) vascular mapping and precise lesion targeting.

RESULTS

Ninety BPA sessions were performed on 19 patients under CBCT-PA guidance. Significant improvements were observed in mPAP (37.0 mmHg [interquartile range (IQR): 28.0-46.0] vs 25.5 [IQR: 22.8-31.5]; P<0.001), PVR (5.5 Wood units [IQR: 3.4-8.5] vs 3.3 [IQR: 2.7-4.6]; P < 0.001), NYHA-FC I-II rate (8 [42%] vs 18 [94%]; P = 0.04), and NT-proBNP (165 pg/mL [IQR: 82-1146] vs 127.0 [IQR: 57-216]; P = 0.014). Overall AE rate was 14.4%, and major AE rate was 7.7% (all Cardiovascular and Interventional Radiology Society of Europe [CIRSE] grade 3). The haemoptysis rate was 4.4%. No periprocedural deaths were reported.

CONCLUSION

BPA performed under CBCT-PA guidance appeared to be an effective and safe approach in the program’s initial period, helping achieving similar results as established centres.

{"title":"Cone beam CT pulmonary angiography in balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension during the program initiation period","authors":"A. Páez-Carpio , F.X. Zarco , E. Serrano , I. Vollmer , J. Puig , J.A. Barberà , F.M. Gómez , I. Blanco","doi":"10.1016/j.crad.2025.106847","DOIUrl":"10.1016/j.crad.2025.106847","url":null,"abstract":"<div><h3>AIM</h3><div>Cone beam CT pulmonary angiography (CBCT-PA) has proven to be a valuable technique during balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH) in established centres. This study aimed to demonstrate the safety and efficacy of CBCT-PA–guided BPA for CTEPH during the initial period of a BPA program. CBCT-PA improves procedural accuracy by visualising distal thromboembolic lesions and providing real-time guidance, which is critical during program initiation.</div></div><div><h3>MATERIALS AND METHODS</h3><div>This single-centre, single-arm study prospectively evaluated patients with CTEPH undergoing BPA from 2017 to 2022. Outcomes of interest included pre-BPA and post-BPA 6-minute walking distance, New York Heart Association Functional Classification (NYHA-FC), mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), N-terminal pro B-type natriuretic peptide (NT-proBNP), and BPA-related adverse events (AEs). Statistical analysis compared pre-BPA and post-BPA results. CBCT-PA was used for three-dimensional (3D) vascular mapping and precise lesion targeting.</div></div><div><h3>RESULTS</h3><div>Ninety BPA sessions were performed on 19 patients under CBCT-PA guidance. Significant improvements were observed in mPAP (37.0 mmHg [interquartile range (IQR): 28.0-46.0] vs 25.5 [IQR: 22.8-31.5]; <em>P<</em>0.001), PVR (5.5 Wood units [IQR: 3.4-8.5] vs 3.3 [IQR: 2.7-4.6]; <em>P</em> < 0.001), NYHA-FC I-II rate (8 [42%] vs 18 [94%]; <em>P</em> = 0.04), and NT-proBNP (165 pg/mL [IQR: 82-1146] vs 127.0 [IQR: 57-216]; <em>P</em> = 0.014). Overall AE rate was 14.4%, and major AE rate was 7.7% (all Cardiovascular and Interventional Radiology Society of Europe [CIRSE] grade 3). The haemoptysis rate was 4.4%. No periprocedural deaths were reported.</div></div><div><h3>CONCLUSION</h3><div>BPA performed under CBCT-PA guidance appeared to be an effective and safe approach in the program’s initial period, helping achieving similar results as established centres.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"84 ","pages":"Article 106847"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical outcomes, toxic effect, and immune microenvironment changes of drug-eluting bead bronchial arterial chemoembolisation/bronchial arterial chemoembolization combined with immunotherapy in treating elderly patients with non–small cell lung cancer

IF 2.1 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology

Pub Date : 2025-02-13 DOI: 10.1016/j.crad.2025.106849

J. Xiang , W. Lan , D. Cai , Y. Wang , W. Li , J. Tu , J. Huang

AIM

Systemic chemotherapy plus immune checkpoint inhibitors (ICIs) are first-line treatment for advanced non–small cell lung cancer (NSCLC). However, elderly patients typically have comorbidities that tend to limit the use of chemotherapy at standard dosage and frequency. Drug-eluting bead bronchial arterial chemoembolisation (DEB-BACE)/bronchial arterial chemoembolization (BACE) represents options in such patients.

MATERIALS AND METHODS

This is a retrospective analysis. We screened all elderly patients (aged ≥70 years) undergoing treatment with immunotherapy plus DEB-BACE/BACE for pathologically confirmed stage III-IV NSCLC with negative driver gene mutations from October 2019 to December 2023 at our hospital. The response was evaluated according to the Response Evaluation Criteria in Solid Tumors version 1.1 criteria.

RESULTS

The final analysis included 46 patients (median age: 76 years; 42 men and 4 women). Eastern Cooperative Oncology Group (ECOG) performance status was either 1 or 2. The median progression-free survival and overall survival were 9.1 months (95% confidence interval [CI]: 8.4-9.9) and 18.2 months (95% CI: 16.5-19.9), respectively, after a median follow-up of 20.3 months (95% CI: 19.5-21.1) in all populations. The most prevalent adverse events (AEs) were myelosuppression (76.1%, 35/46), followed by decreased appetite (71.7%, 33/46), nausea (65.2%, 30/46), and fatigue (54.3%, 25/46). The rate of any grade and grade ≥3 immune-related AEs was 34.8% (16/46) and 6.5% (3/46), respectively. No patients experienced treatment-related deaths, haemoptysis, or unexpected embolisation.

CONCLUSION

DEB-BACE/BACE combined with immunotherapy was effective and well tolerated in elderly patients with advanced NSCLC.

{"title":"Clinical outcomes, toxic effect, and immune microenvironment changes of drug-eluting bead bronchial arterial chemoembolisation/bronchial arterial chemoembolization combined with immunotherapy in treating elderly patients with non–small cell lung cancer","authors":"J. Xiang , W. Lan , D. Cai , Y. Wang , W. Li , J. Tu , J. Huang","doi":"10.1016/j.crad.2025.106849","DOIUrl":"10.1016/j.crad.2025.106849","url":null,"abstract":"<div><h3>AIM</h3><div>Systemic chemotherapy plus immune checkpoint inhibitors (ICIs) are first-line treatment for advanced non–small cell lung cancer (NSCLC). However, elderly patients typically have comorbidities that tend to limit the use of chemotherapy at standard dosage and frequency. Drug-eluting bead bronchial arterial chemoembolisation (DEB-BACE)/bronchial arterial chemoembolization (BACE) represents options in such patients.</div></div><div><h3>MATERIALS AND METHODS</h3><div>This is a retrospective analysis. We screened all elderly patients (aged ≥70 years) undergoing treatment with immunotherapy plus DEB-BACE/BACE for pathologically confirmed stage III-IV NSCLC with negative driver gene mutations from October 2019 to December 2023 at our hospital. The response was evaluated according to the Response Evaluation Criteria in Solid Tumors version 1.1 criteria.</div></div><div><h3>RESULTS</h3><div>The final analysis included 46 patients (median age: 76 years; 42 men and 4 women). Eastern Cooperative Oncology Group (ECOG) performance status was either 1 or 2. The median progression-free survival and overall survival were 9.1 months (95% confidence interval [CI]: 8.4-9.9) and 18.2 months (95% CI: 16.5-19.9), respectively, after a median follow-up of 20.3 months (95% CI: 19.5-21.1) in all populations. The most prevalent adverse events (AEs) were myelosuppression (76.1%, 35/46), followed by decreased appetite (71.7%, 33/46), nausea (65.2%, 30/46), and fatigue (54.3%, 25/46). The rate of any grade and grade ≥3 immune-related AEs was 34.8% (16/46) and 6.5% (3/46), respectively. No patients experienced treatment-related deaths, haemoptysis, or unexpected embolisation.</div></div><div><h3>CONCLUSION</h3><div>DEB-BACE/BACE combined with immunotherapy was effective and well tolerated in elderly patients with advanced NSCLC.</div></div>","PeriodicalId":10695,"journal":{"name":"Clinical radiology","volume":"84 ","pages":"Article 106849"},"PeriodicalIF":2.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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